Chapter 8, Chapter 9, chapter 13, Chapter 14 8ed., Chapter 16 8 ed, Chapter 20 8ed., Chapter 24 8 ed., Chapter 22 8ed., Chapter 15 8 ed. ---- (16 9 ed.), Chapter 21 , 8ed. (22 9ed.), Chapter 23, 8ed. (24 9ed.), Chapter 25 8ed, Chapter 26 8 ed., Chapt...

A group of nurses has been convened to solve a problem. As the first step in this process, the group leader asks for a definition of the problem to be solved. Which statement reflects the best problem statement? 1. Emergency department nurses do not make professional client handoff reports. 2. Long-term-care facility nurses lack the education to make complete assessments prior to client transfers. 3. Housekeepers are getting sloppy about cleaning rooms. 4. Unit clerks have made 10 transcription errors in the last 6 months.

Correct Answer: 4 Rationale 1: This is a judgment statement. Rationale 2: This is a judgment statement. Rationale 3: Getting sloppy is a judgment statement. Rationale 4: A good problem statement reflects the facts without judgment as to cause.

A nursing assistant has taken long lunch breaks for the last 2 days and today is 15 minutes late returning from the cafeteria. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Go to the cafeteria and confront the assistant. 2. Send a message with a nurse going to lunch for the assistant to return to the unit immediately. 3. Call the cafeteria and ask that they send the assistant back to the unit. 4. Meet with the assistant and calmly say, You have been late back from lunch for 3 days this week. 5. Anticipate that the assistant will give an explanation for the lateness.

Correct Answer: 4,5

In an attempt to decrease tardiness, a hospital gives employees an extra hours pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory? 1. Expectancy 2. Shaping 3. Equity 4. Goal-setting

1

A nurse manager elects to ignore a nurses performance problem, hoping it will go away. What does this strategy indicate about the nurses management ability? 1. The nurse is a lazy manager. 2. The nurse is gullible. 3. The nurse is using a valid strategy. 4. The nurse needs an update on management strategy.

3

A student who is about to graduate is discussing the future with a nursing instructor. The instructor asks the student, What schedule are you interested in working? What organization is near your home? The student says that salary is the most important thing. Which response by the instructor would be appropriate? 1. Since you have been in school for so long, the most important thing to you is to get a job that pays well. 2. I would focus on those organizations that pay premium wages for nurses. 3. A small difference in salary is less important than working in an organization where you can obtain your future goals. 4. Money is not important; the job is important.

3

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurses preceptor focus on at this time? 1. Orientation of the nurse to protocols associated with this death 2. Socialization of the nurse to the staff 3. Counseling the new nurse 4. Serving as a role model

3

An ICU nurse does not follow policy when administering a medication intravenously. Which would be the most appropriate action by the manager to assist the employee? 1. Provide written instructions for administering the medication. 2. Remediate the situation with the ICU staff. 3. Provide a copy of the policy and discuss the rationale for the policy as it relates to client care. 4. Reprimand the ICU nurse for giving the medication.

3

The nurse manager identifies a minor problem with the way a staff nurse documents client care. The manager meets with the nurse and discusses the issue, but does not issue a warning. What is the managers next action? 1. Report the meeting to human resources. 2. Enlist the aid of a more experienced nurse to help monitor the documentation. 3. Record the specific behavioral steps discussed for future reference. 4. Tell the nurse that failure to comply with steps discussed will result in a written warning.

3

The nurse manager has identified physical assessment skills lacking in a new registered nurse. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the nurses assessment skills? 1. You need to work on your health assessment skills before your next employee evaluation. 2. Get someone to help you with your health assessment skills by the end of the month. 3. Read a health assessment book and practice your skills. 4. Plan to study one body system a week and demonstrate your assessment skills to me every week

4

Question 6 A human resources (HR) manager knows which method of recruitment is most likely to be productive and inexpensive? 1. Internet websites 2. Advertisements in professional journals 3. Employee referrals 4. Job fairs

Correct Answer: 3

The staff has complained that a nurse receives frequent personal phone calls, which is a violation of policy. In what manner should the manager address this nurse? 1. Meet with the nurse privately and inquire as to the necessity of personal phone calls. 2. Meet with the nurse and give a verbal warning. 3. The manager should inform the nurse the other nurses are complaining about the phone calls. 4. Tell the complaining nurses to handle the situation with peer pressure.

Correct Answer: 1

Question 8 Type: MCSA During the interview a nurse learns there are several people interviewing for the position. Several days postinterview the nurse is called for a second interview. How should the nurse prepare for this interview? 1. Prepare in the same way as for the first interview. 2. Prepare in a similar way as for the first interview but with more details regarding past experiences. 3. Anticipate questions in regard to the position that are situational and provide information regarding competence. 4. Anticipate questions about goals for the future.

Correct Answer: 3

Which statement by the nurse manager is the best example of day-to-day coaching? 1. Can we meet this afternoon for about 30 minutes to discuss your progress? 2. I think you need to get different day care that would allow you to be on time. 3. Over the past 6 months the narcotics count has been off on several days that you have worked. 4. Let me show you a method I have found to be effective in making patient assignments.

Correct Answer: 4

The registered nurse has had recent difficulty finishing and documenting client care during the assigned shift. The nurse has historically had very good appraisals, and the climate of the unit has not changed. Which would be the best approach to correct recent behaviors? 1. Provide education 2. Simplify tasks 3. Clarify expectations 4. Reassign the nurse to another unit.

3

A nurse manager and an employee meet to discuss the employees appraisal. They disagree on the content of the employee evaluation. The disagreement turns into an argument. Which is the best managerial strategy in this situation? 1. Postpone the interview. 2. Agree on arbitration. 3. Seek input from employee peers. 4. Report the employee to the human resources manager. A nurse manager and an employee meet to discuss the employees appraisal. They disagree on the content of the employee evaluation. The disagreement turns into an argument. Which is the best managerial strategy in this situation? 1. Postpone the interview. 2. Agree on arbitration. 3. Seek input from employee peers. 4. Report the employee to the human resources manager.

1

A nurse manager overhears a conversation in which staff nurses complain about the evaluation process. One nurse says, It really is just a waste of time. I get the same raise no matter what Im rated. Which is the best way for the manager to address this concern? 1. Lobby administration to implement raises based on merit. 2. Call the nurse aside and state agreement with the complaint. 3. Report the episode to the chief nursing officer. 4. Emphasize the practice development aspects of evaluation.

4

What is the primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy? 1. To punish the guilty 2. To protect the institution from liability 3. To set an example for other employees 4. To encourage the correct behavior

4

A nurse has been asked to teach newly hired nurses how to operate some client care equipment that the unit has just received. The nurse says, Id love to do this, but someone else will need to take my clients today. How should the manager respond? 1. You will need to work the education into your day as you take care of clients. 2. This will be a good break for you. 3. You can use the classroom in the hospital basement for your instruction. 4. I will authorize your additional salary for the next pay period.

1

A nurse manager is considering referring a nurse who is very stressed to the employee assistance program (EAP) offered by the institution. What does this consideration indicate? 1. The manager believes this service would promote the nurses health and well-being. 2. The manager thinks the nurse is abusing alcohol to cope with the stress. 3. The manager thinks that this referral will help the nurse avoid sanction by the state board of nursing. 4. The manager believes the nurse is abusing controlled medications to cope with stress.

1

A staff nurse is not meeting job expectations. The manager has followed some standard strategies such as counseling to try to motivate the nurse, but they have not been successful. When discussing the situation with the supervisor, the manager says, I think I will try shaping strategies. What can the supervisor expect of the staff nurses performance? 1. It should gradually move toward the expected behaviors. 2. The behaviors will likely get worse before they get better. 3. The nurse will probably get frustrated and resign. 4. Performance should be at expected levels within a week.

1

An emergency department (ED) manager is disciplining a nurse with a history of multiple client and staff complaints. The last disciplinary action was a verbal warning. If the institution follows the progressive method of addressing disciplinary issues, the manager would prepare for which action? 1. A written warning 2. A counseling session 3. Another verbal warning 4. Termination

1

It has been reported to the nurse manager that an employee is repeatedly parking in the patient/visitor parking area. What action should the manager take? 1. Confront the employee. 2. Check the parking lot each morning. 3. Discuss the issue at the next employee appraisal. 4. Provide an education session for all staff regarding parking policy.

1

The chief nursing officer (CNO) recognizes a large increase in turnover on a given unit. The nurse manager of the unit says that this is just a coincidence and that the unit is fine. What action by the CNO is appropriate? 1. Talk to current nursing staff and review the exit interviews of those who have left. 2. Call the unit supervisor and inquire as to why the turnover rate is high. 3. Discuss the matter with other nurse managers. 4. Discuss the matter with the hospital chief administrator.

1

The nursing unit has experienced high stress and a higher than normal turnover rate. The manager asks a longtime member of the nursing staff to analyze the managers job performance. What is most likely the reason for this request? 1. The manager is questioning his or her leadership style and its effectiveness. 2. The manager is required to ask for input on his or her personal job evaluation. 3. The manager is attempting to show concern about unit conditions. 4. The manger is inquiring about other leadership styles the nurse has encountered.

1

Type: MCSA A nurse manager is discussing the hospitals changes to peer evaluation with nursing staff. Which comment by a staff nurse would the manager interpret as evidence of understanding this process? 1. Our evaluations will be more objective. 2. This must be a less expensive method of evaluation. 3. This should be quicker than our existing method. 4. This would be a good way to get back at the nurses who dont work as hard.

1

An emergency department nurse manager is preparing for a night-shift nurses annual appraisal. The manager is apprehensive because there are issues to address regarding rudeness and unprofessional behavior. How should the manager prepare for conducting this appraisal? 1. Place the evaluation in an envelope with specific details addressing the nurses behavior and allow the nurse to review it during his or her next shift. 2. The manager should complete the evaluation and ask a peer to review it and provide feedback. 3. The manager should arrange a 2030 minute meeting with the nurse to discuss the evaluation privately. 4. The manager should allow the human resources manager to conduct the appraisal.

3

A director has performed an annual appraisal of the ICU manager, which reflects several issues in regard to the managers attitude. At the end of the interview the manager expresses disagreement with the appraisal. The director instructs the manager to sign the appraisal and ends the interview. The manager reports this situation to the human resources director for which reason? 1. The interview was conducted in an unprofessional manner. 2. The appraisal could be interpreted as discriminatory. 3. The appraisal was not a fair evaluation of the managers work. 4. The director appraised the managers attitude which is unprofessional.

2

A medical-surgical nurse manager has received a complaint by a client regarding the noise level on the unit. The manager reviews the schedule and harshly reprimands the nursing staff who cared for the client. What is the evaluation of this managers action? 1. It is appropriate and timely. 2. The action is inappropriate and increases the nursing staffs level of stress. 3. The action is inappropriate and should be reported. 4. It is appropriate and should be a model for future disciplinary actions.

2

A newly hired certified nurses aide (CNA) has been 15 minutes late returning from mealtime 4 days this week. The nurse manager coaches the employee and finds the CNA thought meal breaks were 45 minutes. What is the most appropriate response from the nurse manager? 1. Document the tardy behavior in the CNAs record. 2. Show the CNA the break hours in the employee handbook. 3. Warn the CNA tardiness is not tolerated and follow up in 2 weeks. 4. Warn the CNA that the charge nurse will be timing future meal breaks.

2

A nurse has frequent visitors while working. The manager has discussed with the nurse the negative effect of these visits on client care. What should the manager do next? 1. Ask staff if the visits have decreased. 2. Arrange a follow-up meeting with the nurse. 3. Counsel all nursing staff regarding the limitations of personal visitors. 4. Arrange to be visible on the nursing unit when this nurse is working.

2

A nurse manager gives a staff nurse an exceptional appraisal. The other nurses learn of the appraisal and are upset because this nurse has had numerous complaints from peers regarding laziness. The manager informs a colleague the nurse obtained an exceptional appraisal because the nurse will always work for me when I need extra help to come in. This is an example of which problem in evaluating? 1. Recency error 2. Leniency error 3. Ambiguity error 4. Halo error

2

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first? 1. Evaluate each employees educational and experiential background. 2. Establish, in writing, the expectations of each task. 3. Consider how much variation from standard is acceptable. 4. Review unit statistics for incidents, errors, and accidents.

2

A nurse who has worked in the dialysis unit for the past 5 years is considering a career change. The nurse is unsure whether to follow a management or a clinical career path. Which would be a good beginning step for this nurse? 1. Enroll in a graduate nursing program. 2. Investigate careers by talking with nurses in those positions. 3. Investigate the salary options for various careers. 4. Seek advice from the manager of the unit.

2

A nurse who receives frequent phone calls informs the manager the phone calls are related to a health crisis concerning a family member. Other nurses also receive personal calls, but not as many as the first nurse. Which action by the manager is appropriate? 1. Tell the nurse to have family call the managers office if there is a crisis. 2. Discuss with the nurse how personal phone calls may affect client care and should be limited. 3. Inform the nurse the phone calls are causing morale issues among the staff. 4. Lift the policy against staff carrying personal cell phones for this nurse while the crisis continues

2

During an interview for a night shift ICU position, the manager asks the job candidate, Will working the night shift interfere with your husbands schedule? How should the candidate interpret this question? 1. It is a legitimate question. 2. It is an illegal question to ask. 3. It is none of the managers business. 4. It is something the candidate should consider.

2

During the review of an organizations appraisal policies, a nurse consultant finds that the facility uses a traditional rating scale based on general performance. What would be the consultants greatest concern with this choice of appraisal style? 1. It is time consuming for the manager to write the evaluation essay required by this method. 2. Ratings are based on the supervisors idea of satisfactory performance. 3. The standards used are so specific that they do not allow for individual variation. 4. Since this style involves input from peers, there is room for problems with confidentiality

2

Question 29 A nurse manager is aware that U.S. citizenship is required by a job position being filled. How should the manager handle this requirement during the job interview? 1. Ask the applicant to provide proof of citizenship before the interview is scheduled. 2. Ask the applicant if he or she is an U.S. citizen. 3. Do not ask unless the applicant mentions citizenship. 4. Ask if the applicants family is from the United States.

2

The emergency department (ED) has seen an increase in violent behavior over the past year. The manager has voiced concerns to the chief nurse officer (CNO) regarding the safety of the ED staff. What should be done as a first step in addressing this issue? 1. The manager should consult with local law enforcement. 2. The CNO should review the management of violent incidents procedure policy. 3. The CNO should discuss the matter with hospital security. 4. The CNO should have the manager discuss the matter with the ED staff.

2

The manager has disciplined a nurse with a written warning. At the end of the session, the manager asks the nurse to sign the warning and the nurse refuses. What should the manager do? 1. Tell the nurse that signing the form in mandatory. 2. Indicate on the form that the nurse declined to sign. 3. Sign the nurses name to the form and include the managers initials. 4. Complete a second warning for the nurses failure to follow procedure.

2

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coachs job? 1. Get the nurse to explain the cause of the dissatisfaction. 2. Conduct the relationship in a confidential manner. 3. Encourage the nurse to stay in the organization. 4. Help the nurse increase bedside skill competency.

2

The nurse manager asks a nurse to become a charge nurse, but then frequently questions the nurses daily decisions. This situation reflects which problem that will increase the nurses stress? 1. Reality shock 2. Role ambiguity 3. Role conflict 4. Burnout

2

The nurse manager holds a staff meeting and announces, I want to aggressively manage the stress on this unit. Why would the manager have this goal? 1. Stress has a negative impact on the functioning of the unit. 2. If the stress level is too low, people become apathetic and bored. 3. Low stress levels will reduce turnover on the unit. 4. Coping mechanisms only work when stress is high.

2

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice? 1. A nurse who needs the temporary pay increase that accompanies precepting 2. A nurse who is clinically competent and has the desire to assume the responsibility to train new staff 3. A nurse who has expressed the desire for additional training and unit responsibilities 4. The nurse who needs to work an 8-hour schedule for a few weeks while recovering from a work-related accident

2

The nurse was reported for not following unit policy in relaying a clients complaint regarding another staff member. During a meeting, the nurse insists he managed the situation appropriately. How should the manager respond? 1. Lets schedule another meeting for later in the week after you have had time to reflect on the situation a little more. 2. Lets explore some alternative solutions to what happened. 3. I am going to request a meeting for both of us and the human resources director. 4. As I see it, the problem is your inability to follow the simplest of unit policies and to take direction.

2

The nursing administration has instituted a horizontal promotion system within the nursing department. What benefit is this program to the staff nurse? 1. The most competent nurses will rise to managerial positions. 2. It rewards the nurses clinical excellence. 3. Over time the nurse will move steadily upward through the levels. 4. The process is practice based rather than research based.

2

When the nurse manager orders supplies for the unit, which communication mode is best? 1. Telephone 2. E-mail 3. In person 4. Voice mail

2

A nurse manager is selecting nurses to serve as teachers in on-the-job instruction. What qualifications should these nurses hold? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. At least one nursing degree higher than those being taught 2. Willingness to teach new nurses 3. Ability to explain procedures accurately and clearly 4. Formal instruction in educational methodology 5. Experience as a clinical preceptor

2,3

During strategic planning, the committee finds a need to develop a succession plan for the facility. What committee findings would draw attention to this need? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. More nurses are electing to move into management positions. 2. Many of the facilitys senior nursing managers indicate they will likely retire within 5 years. 3. The nursing shortage in the area continues to worsen. 4. Salaries continue to rise, making profitability low. 5. Many of the nurses moved into leadership positions fail.

2,3

An experienced nurse manager is serving as mentor to a newly appointed manager. The experienced manager says, Always try to keep your staff as well informed as possible about what is going on at the administrative level. What rationale should the manager offer for this advice? 1. Nursing involvement at the administrative level is required by accrediting agencies. 2. Involvement of all departments in the agency supports the organizations management style. 3. Staff members who are kept informed are less likely to be suspicious and spread rumors. 4. Sharing both the positive and negative information from administration helps to reduce the managers stress.

3

Coaching and discipline have failed and the nurse manager is faced with no alternative but to terminate an employee. Which aspect of this situation requires the most careful planning? 1. When the termination will occur 2. How to keep the human resources department informed 3. Accurately documenting all stages of the situation 4. Whether the termination will adversely affect unit staffing

3

The hospital has elected to initiate a rotating 8-hour shift schedule. Which strategy, taken by the nurse manager, will help staff cope with the stress associated with this staffing pattern? 1. Rotate the shifts several times each month so no one is on one shift very long. 2. Rotate the nurses among all shifts so that they know the concerns of each shift. 3. Be certain that nurses are taking their meal and work breaks each shift to increase rest. 4. Schedule a double back at the end of each rotation to allow new rotations to start uniformly.

3

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance? 1. A coupon for free lunch for staff members each time they use the tool 2. A counseling session with the nurse manager when the assessment tool has not been used 3. A coupon for a free lunch for staff members who, according to a medical record review of nursing documentation, consistently use the tool correctly 4. A pizza party for the staff when there is 100 percent compliance

3

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation? 1. Choose one theory that the manager thinks best suits the situation. 2. Review several theories but use no more than two. 3. Combine theories to develop a plan for this specific unit. 4. Review the motivational theories, but dont depend on any of them to work in the real world.

3

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentorprotg relationship? 1. The protg will select the mentor. 2. Once established, this relationship lasts forever. 3. The relationship will develop through stages. 4. Mentors are generally of the opposite gender as the protg.

3

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique? 1. Pairing a newly licensed nurse with a nurse who has worked on the unit for 5 years 2. Matching a newly hired male nurse with a newly hired female nurse 3. Pairing a nurse with conflict management experience with an employee who has expressed dissatisfaction with the job 4. Matching nurses who have similar educational and cultural backgrounds when selecting participants for an educational offering

3

The staff nurse has challenged the appraisal rating given by a new nurse manager. What should the nurse manager do? 1. Do not change the rating as that will undermine the managers authority. 2. Change the rating immediately as the staff nurse has more experience than the manager. 3. Investigate the staff nurses challenge and change the rating if it is justified. 4. Ask another staff nurse to act as a mediator in the challenge.

3

A nurse manager has discussed behavioral and unprofessional behaviors with a nurse. During the performance appraisal the manager addressed these issues and the two nurses have developed a specific plan to address the performance areas that can be strengthened. What should the managers next course of action be? 1. Take notes of the nurses behavior during the appraisal. 2. Inquire as to the nurses perception of the appraisal. 3. Schedule a follow-up session to determine if the nurse has made progress in the areas specified. 4. Schedule the next annual appraisal.

3

A nurse manager praises a staff nurse by saying, You are such a perfectionist and it clearly shows in your work. The supervisor who hears this praise is concerned for which reason? 1. Giving such high praise to a staff nurse may result in the nurse asking for a raise. 2. The manager should not praise a staff nurse so highly in front of other nurses. 3. The manager may be promoting a trait that often leads to constant stress. 4. This type of praise often leads to the nurse behaving in a superior manner when around the other nurses.

3

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employees frustration is most linked to which motivational theory? 1. Reinforcement theory 2. Process theory 3. Content theory 4. Equity theory

3

A rural hospital has been at capacity for the past 3 months. The chief nursing officer (CNO) has heard numerous complaints from the nursing staff. Most of the complaints are issues related to other nursing departments and are minor. How should the CNO interpret these complaints? 1. The nursing staff members are inefficient in managing the client load. 2. This is a typical reaction among nursing departments. 3. The nursing staff is stressed due to a sustained increased workload. 4. The nurses are ready to unionize

3

A staff nurse tells the nurse manager, I dont know how you do it. You manage the unit, work extra shifts, and have so many people depending on you and yet you seem so calm and in control. What explains this nurses perception? 1. Nurse managers dont do much direct client care, so their work is predicable. 2. The staff nurse is trying to manipulate the manager. 3. The manager has excellent coping skills and high stress tolerance. 4. Some people do a very good job of hiding their stress.

3

An OB manager discusses a nurses performance with the chief nurse officer (CNO). The CNO learns the nurse has had multiple client and physician complaints that the manager investigated and for which counseling was provided. The behavior continues even though the nurse has received verbal and written warnings. Which course of action would be most appropriate at this time? 1. Issue a written warning from the CNO. 2. Place the nurse on suspension pending a new investigation into the complaints. 3. Terminate the nurse. 4. Transfer the nurse to another department under another manager.

3

The manager is contemplating terminating a nurse. What should the manager consider regarding the expectations of the job prior to proceeding with termination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Did the nurse receive and sign for a copy of the appropriate job description when hired? 2. Was the nurse apprised of the criteria on which evaluation would be based? 3. Have any changes to policy and procedure been discussed with the nurse and made available in writing? 4. Was the nurse hired using the same documentation as others hired at the same time? 5. Have others hired during the same time period been successful?

123

In order to develop a succession-planning program as rapidly as possible, the management team has elected to divide the processes up among team members. Which assignments would be expected? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Identify the most important things that managers do. 2. Find out how much managers in the local area hospitals are paid. 3. Decide which current nurses would make good managers. 4. Analyze management training opportunities. 5. Research generational change theory.

134

Which job behaviors would the nurse executive consider troublesome no matter which unit employed the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse made two medication errors today that resulted in poor client outcomes. 2. A nurse was tardy twice last month due to car trouble. 3. A manager reports that a nurse used a piece of equipment that had been taken out of service for malfunction. 4. A nurse did not report to work for 2 days and did not call in the absence. 5. A physician calls to complain that a nurse was rude.

134

A charge nurse has been trying to please all the nurses, physicians, clients, and staff of the unit. This has caused considerable stress for this nurse. After a few days off the nurse decided to manage the role differently. What has occurred to the nurse over these days off? 1. Role conflict 2. Role definition 3. Role redefinition 4. Interrelated conflict

3

An employee has consistently violated policy and has not responded to coaching. The manager has decided that discipline is required. What should the manager do first? 1. Plan a private meeting for the disciplining. 2. Wait for one more infraction to occur and discipline immediately afterward. 3. Make certain that the information regarding policy violations is correct. 4. Keep the human resources department informed.

3

Question 6 Type: MCSA The nurse executive of a hospital is surveying hospitals in a four-state area in regard to their disaster preparedness. The nurse would expect to hear which response to the question What have you done to prepare for a disaster? 1. We have conducted a drive to get area health care professionals registered so they can be contacted in case of a disaster. 2. We have a designated place with beds and equipment so that staff can be directed to an alternate care area. 3. We have not prepared for a disaster. 4. We conduct practice disaster drills. Correct Answer: 4

Rationale 1: Only half of the hospitals in the United States have conducted health care professional registration. Rationale 2: Only about half of hospitals report having plans for an alternative care delivery site with beds and equipment. Rationale 3: Most hospitals have at least some level of preparation for a disaster. Rationale 4: Over half of U.S. hospitals report conducting practice disaster drills.

The nurse manager routinely experiences stress related to deadlines for projects. What should be the nurses first action to control this stress? 1. Identify the actual stressor and the precipitating factors. 2. Plan activities to minimize time constraints to reduce stress. 3. Set aside a block of time each day for stress reduction. 4. Engage in distraction activities to minimize the stress.

orrect Answer: 1 Rationale 1: The first step of the nursing process is to assess the situation. Rationale 2: Before a plan can be made, the stressor must be assessed. Rationale 3: Implementation occurs after the stressor has been assessed and a plan developed. Rationale 4: Implementation occurs after the stressor has been assessed and a plan developed.

Question 3 Type: MCSA As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item? 1. The fixed cost 2. The variable cost 3. The indirect cost 4. The direct cost

Correct Answer: 3 Rationale 1: Fixed costs are costs that will remain the same for the budget period regardless of the activity level of the organization. Rationale 2: Variable costs depend on and change in direct proportion to client volume and acuity. Rationale 3: Indirect costs are expenditures that are necessary but do not affect client care directly. Rationale 4: Direct costs are expenses that directly affect client care such as nursing personnel who provide hands-on client care.

A nurse enters a client's room and sees a visitor threatening the client. The nurse questions the visitor in a nonthreatening manner. The visitor begins to threaten the nurse. What should the nurse do in this situation? 1. Keep a safe distance from the visitor. 2. Yell for another nurse to assist with the visitor. 3. Leave the room. 4. Threaten the visitor with assault charges.

Correct Answer: 1

A nurse has joined the local Sigma Theta Tau organization. The nurse is hoping to find a mentor within the organization. Which person would be a good candidate? 1. A senior nurse who has the career experience that the nurse is interested in pursuing 2. The president of the organization 3. A senior nurse who has a wide range of career experiences 4. A member of the board of the organization

Correct Answer: 1

A nurse who is a chronic complainer comes back from lunch 20 minutes late. When confronted by the manager the nurse says, the nurses who smoke always take longer lunches. No one says anything to them. What is the managers major consideration before replying to this statement? 1. Policies must be consistently applied to all employees. 2. Since the hospital is smoke free, those nurses who wish to smoke must leave campus for lunch. 3. This nurse complains about everything. 4. The human resources policy is that nurses get 60 minutes for lunch.

Correct Answer: 1

Question 16 A manager has documentation to suspect substance abuse by a nurse. The manager meets with the human resources (HR) director to determine which course of action should be taken to abide by the organizations policies. Which statement by the HR director is appropriate? 1. We should meet with the nurse and offer access to the employee assistance program. 2. We should confront the employee and discuss involuntary or voluntary termination. 3. You need to meet with this nurse and confront these behaviors. 4. We need to set up a counseling session with a psychologist and this nurse.

Correct Answer: 1

Question 19 A chief nurse officer (CNO) of a rural hospital is meeting with department directors and the human resources officer to discuss the hospitals recruitment strategies. A newly promoted director suggests a recruitment fair at a metropolitan city 100 miles away. The CNO rejects this proposal. Which option is likely the CNOs rationale for this decision? 1. The CNO would prefer to focus on the local area initially. 2. A metropolitan area is not a good area in which to recruit for a rural hospital. 3. Metropolitan nurse's skills are too advanced for a rural hospital. 4. The director is new to the role and the CNO does not respect the nurse's opinion

Correct Answer: 1

Question 24 An emergency department (ED) manager interviews and hires a candidate who reports having several years of ED experience. Soon after hire, the nurse makes a series of errors and harms several clients. When investigating these errors, the nurse manager discovers the nurse falsified his experience and credentials. Is the hospital liable for this nurse's actions? 1. Yes, the hospital could be liable for negligent hiring if credentials were not checked. 2. Yes, the hospital could be liable but only if it did not properly train the nurse. 3. No, the nurse is liable because information about experience was falsified in the interview. 4. Yes, the hospital is liable for all errors committed by nursing staff.

Correct Answer: 1

Question 5 Type: MCSA A nurse who has an interview with the human resources (HR) director enters the office, doesnt make eye contact, and is very timid. Toward the end of the interview the HR director asks the nurse if there are any questions. The nurse states, No, I think Ive learned all I need to know. What impression has this nurse given the HR director? 1. Lack of interest in the position 2. Shyness and the inability to manage people 3. Rudeness 4. Laziness

Correct Answer: 1

Question 5 Type: MCSA An ICU nurse has just assisted the physician in placing a central line in a client. Over the past few days the client's son has been increasingly verbally abusive to the nursing staff. The unit secretary tells the nurse that the son is at the nurse's station demanding to see the client. Which action by the nurse is most important? 1. Remove the central line tray from the room. 2. Inform the son regarding the client's condition. 3. Ignore the son as he enters the clients room. 4. Limit the son's visitation.

Correct Answer: 1

Question 19 Type: MCSA Which situation requires an adaptive decision? 1. The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state. 2. The nurse has made a medication error on an experimental medication. 3. The nursing student makes an error when changing a client dressing. 4. The nurse manager scheduled too many nurses for the client census on the night shift, and all of the nurses scheduled have already been asked to take a low-census unpaid day off this month.

Correct Answer: 1 Rationale 1: Adaptive decisions must be made when the situation is unusual and there is no clear-cut policy for decision making. Rationale 2: Making a medication error is not an unusual situation, and a policy exists for handling this issue. Rationale 3: A policy exists for handling procedure errors. Rationale 4: A policy exists for handling staffing errors.

A nurse manager is working on several projects and is stressed most of the time. This manager prefers working at the unit desk instead of in the office to be certain nothing on the unit is missed. Which would be the most effective method to decrease this managers stress? 1. Keep a structured schedule for work time on each project in the office. 2. Elicit assistance from employees to help complete the projects. 3. Allow one project to fall behind while finishing up the others. 4. Take a sick day to work on the projects uninterrupted at home.

Correct Answer: 1 Rationale 1: Carving out work time for each project in the office with a clear place to work is the most effective method to decrease this managers stress. Rationale 2: Eliciting help from employees is not the most helpful option provided. Rationale 3: Allowing one project to fall behind to work on others will not decrease stress in the long term. Rationale 4: Taking a sick day and working on projects at home is not an appropriate management behavior.

A nurse who has been abusing narcotics is in the nurse executive's office discussing the charges. The nurse executive is trying to convince the nurse to seek treatment for the abuse. Which statement should the nurse executive make? 1. Health insurances generally pay 100 percent of treatment charges for medical professionals who are seeking help. 2. If you go to treatment, the state board will never know you were abusing. 3. Treatment is your best chance at returning to practice. 4. We will be able to follow your progress through reports from your treatment team.

Correct Answer: 3

An ICU nurse has been approached by a colleague to join the American Association of Critical Care Nurses. The nurse asks the colleague, Why would I want to join this organization? Which would be the best response? 1. It will further your career. 2. It looks good on your resume. 3. It will help you to network and enhance your learning. 4. You have to join before you can obtain critical care certification.

Correct Answer: 3

An OB nurse is caring for an unmarried woman who is in labor. The nurse learns the client is unwilling to name the baby's father. A male visitor who comes to visit the client raises the nurses concern that he might be violent. Which behavior would raise this concern? 1. The visitor states, I am the baby's father. 2. The client is very anxious with the visitor present. 3. The visitor moves into the nurse's personal space when asking about the client's status. 4. The visitor sits in a chair in the corner of the client's room, rocking and smiling constantly

Correct Answer: 3

Question 16 The chief nurse officer (CNO) receives a call that the candidate for a nurse opening has arrived, but that the unit manager who was to have interviewed the candidate had to work an unscheduled night shift and is unavailable. Which action by the CNO is appropriate? 1. Inform the candidate the interview will have to be rescheduled. 2. Have the HR department refer the candidate to a nurse on the unit. 3. The CNO should conduct an initial interview and arrange for a second interview with the manager. 4. The CNO should call the manager and conduct an interview via a conference call.

Correct Answer: 3

Question 20 Two staff members have a long-standing dislike of one another. Generally, they hide their feelings, but occasionally they engage in name-calling and derogatory remarks. Today their dislike erupted into a shoving match in the break room. How should the manager handle this situation? 1. Tell the two staff members to go to the manager's office immediately. 2. Send both of the employees off the unit. 3. Immediately call for security. 4. Stand between the employees and tell them to calm down.

Correct Answer: 3

Question 20 Type: MCSA A nurse is considering graduate school. The nurse is interested in becoming a nurse practitioner. This nurse has worked as a medicalsurgical nurse for the past 10 years. Which opportunity would benefit this nurses career? 1. Taking a position as an assistant nurse manager 2. Applying for a nurse manager position on a renal unit 3. Transferring to the ICU unit 4. Transferring to the oncology unit

Correct Answer: 3

Question 30 During an interview, the manager has a strong impression that the applicant is a good fit for the position. How should the manager proceed? 1. Offer the applicant the job. 2. Cancel the remaining interviews for the position. 3. Keep this feeling in mind but do not make a hasty decision. 4. Tell the applicant that he or she is the strongest candidate for the position.

Correct Answer: 3

Question 8 Type: MCSA A nurse manager does not like conflict and would like to allow instances of bullying to go away on their own. What rationale by the managers supervisor is the most important? 1. The Joint Commission requires that we address instances of bullying. 2. We don't want to run off good nurses. 3. If you let bullying go, it just gets worse and more frequent. 4. A bully makes the work environment unpleasant for everyone.

Correct Answer: 3

The ICU staff has been dealing with several distractions over the last week. There was a scheduling error caused by a change in the staffing matrix and miscommunication between management and administration. The staff is also caring for a client whose family has been verbally abusive and threatening. The manager notes an increase in absenteeism with the staff over the past 2 days. To which of these distractions is the absenteeism most likely related? 1. The staffing dilemma caused by the scheduler 2. The change in the staffing matrix 3. The decline in staff morale due to a hostile environment 4. The miscommunication between management and nursing administration

Correct Answer: 3

The unit nurses take turns filling the charge nurse role. Which statement reveals risk for development of role conflict in these nurses? 1. I think I do a better job as charge nurse than the other nurses. 2. I like being charge nurse better than being a staff nurse. 3. Sometimes it is just faster to do things myself. 4. I have difficulty with understanding report from the previous shift.

Correct Answer: 3

Type: MCSA A nurse has decided to relocate to another state. Which entry on this nurses resume will be most useful in searching for a new job? 1. Boy Scout leader for 3 years 2. Member of Sigma Theta Tau International 3. Six years work experience as nurse manager in ICU 4. Graduated with honors from a BSN program

Correct Answer: 3

During a job interview the nurse manager asks, What are your short-term goals? Which statement by the applicant addresses this question? 1. I want to become a nurse anesthetist within 10 years. 2. I will be available to come in for extra shifts if needed. 3. My brother and I want to go to on a mission trip in the next year. 4. I want to get this job so I can move on to the next part of my life.

Correct Answer: 3 Rationale 1: Becoming a nurse anesthetist in 10 years is a long-term goal. Rationale 2: Being available to come in for extra shifts is not measurable and is not a goal. A short-term goal statement would be, I hope to work at least three extra shifts each month. Rationale 3: Going on a mission trip is a short-term goal because it involves a time frame of the next 6 months to a year. Rationale 4: Getting a job and moving on with life are not goals. A short-term goal statement would be, I want to work and save $5,000 in the next year.

The nurse manager holds a regular Wednesday meeting with the charge nurses on the unit. There is no new information to discuss this Wednesday. What should the manager do? 1. Hold the meeting so that the charge nurses do not feel that the meetings are not important. 2. Hold the meeting, but only meet for 10 minutes instead of the usual 60 minutes. 3. Reschedule the meeting for Thursday. 4. Cancel the meeting.

Correct Answer: 4 Rationale 1: There is no reason to hold a meeting that is not necessary. Rationale 2: Holding a meeting that lasts only 10 minutes is a waste of the nurses time. Rationale 3: There is no reason to reschedule a meeting if there is no information to discuss. Rationale 4: If there is no reason to hold a meeting, it should be canceled.

The nurse has been concentrating on improving personal communication skills. Which option represents the final step in this nurses work to improve communication? 1. Think about the goals of the communication. 2. Develop an appropriate and thoughtful response. 3. Decide how to say what you want conveyed. 4. Ensure the communication is understood.

Correct Answer: 4 Rationale 1: Thinking about the goals is assessment. Rationale 2: Developing an appropriate response is an implementation. Rationale 3: Deciding how to say what you want conveyed or how to deliver your response is an implementation or plan. Rationale 4: Ensuring all parties understand the communication is the last step as it involves evaluation.

Question 1 Type: MCSA The nurse manager is educating staff about the collective bargaining process. Who should this nurse say controls collective bargaining in health care? 1. The judicial system 2. Individual hospitals 3. Nurses unions 4. Federal laws

Correct Answer: 4

A nurse hears screaming from a client's room. A male visitor leaves the clients room. Which is the nurse's priority action? 1. Call the police. 2. Notify the clients physician. 3. Follow the visitor. 4. Check on the client.

Correct Answer: 4

A director must discipline an ICU manager. The director and manager have become friends. When disciplining the manager, what is the best approach by the director? 1. Notify the human resources director that the meeting will occur. 2. Include the chief nurse officer (CNO) in the session. 3. Ask a manager from another department to sit in on the meeting. 4. Discuss the issue, concentrate on the issue, and do not make it personal.

4

An employee is sabotaging the work of a newly oriented charge nurse, and the charge nurse has not been successful in addressing the problem. When the nurse manager addresses the issue, which is the most appropriate statement? 1. I know it must be frustrating working with a new charge nurse, but how can we make this situation better? 2. This is not professional behavior, and you need to stop it or you will lose your job the next time I hear about it. 3. I know the charge nurse is new to the role, but you should get used to it or there will be more changes. 4. I know the new charge nurse is difficult to work with, but please help make the job easier to do.

1 Rationale 1: Acknowledging the persons frustration validates his or her feelings, and asking for input helps makes him or her part of the solution. Rationale 2: This statement is confrontational and is unlikely to result in a positive response from the employee. Rationale 3: Threatening the employee, no matter how veiled the threat, is confrontational and is unlikely to result in a positive response. Rationale 4: Patronizing remarks are condescending and are not likely to result in a positive employee response.

A nurse manager is investigating the application of the principles of equity theory to rewarding staff. Which options are rewards that the manager could influence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Job satisfaction 2. Prestige 3. Pay 4. Ability 5. Effort

1,2

A certified nurses aide (CNA) has been reported to the nurse manager for refusing to perform hand hygiene between clients when providing morning care. Which statement by the nurse manager would be the most effective? 1. Do you need a class on hand hygiene? 2. Forgetting to perform hand hygiene between clients can spread infection. 3. Why do you refuse to perform hand hygiene? 4. If I hear of any more instances of you not performing hand hygiene, I will write you up.

2

A charge nurse on the night shift did not notify the anesthesiologist regarding an emergency case. The manager investigated the matter and learned the charge nurse thought the primary care nurse would call the anesthesiologist. Which response by the manager would be most appropriate? 1. It is in your job description and your duty. 2. It is your responsibility. In the future, call anesthesia and transfer the call to the primary nurse. 3. Its not the surgery nurses responsibility to call anesthesia! 4. Why was this considered an emergency case?

2

A nurse has been pulled from the surgical unit to the ICU unit and is asked by an ICU nurse to administer a medication that requires monitoring the cardiac rhythm. When asked about the clients cardiac rhythm after the medication was administered, the surgical nurse states, I dont know. What actions should be taken by the units nurse manager? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Meet with the ICU nurse to discuss the situation. 2. Meet with the surgical nurse to discuss the situation. 3. Give a written warning to the surgical nurse for not following policy. 4. Give a written warning to the ICU nurse for not following policy. 5. Meet with the nurses together and issue an informal verbal warning to both

12

A disagreement has arisen between two staff nurses. Both have discussed the situation with the manager. The manager feels that that problem is likely self-solving. How should the manager approach this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Allow some time to pass to see if the situation resolves. 2. Support both nurses as they work through this issue. 3. Provide any resources the nurses may need to help solve the problem. 4. Intervene if the problem begins to impact client care. 5. Ignore the situation.

1234

A nurse executive is trying to convince the hospital management team that a clinical ladder system would work well in nursing. Which points should the nurse include in this argument? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Clinical ladders keep very good nurses at the bedside. 2. These programs prove to be worth their cost. 3. These programs reveal substandard nurses quickly so they can be terminated. 4. Similar programs have been shown to improve nurse job satisfaction. 5. Quality of client care increases with these programs.

1245

A nurse manager has scheduled several on-the-job instruction sessions. Why would the nurse choose this format? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. It is very cost-effective. 2. Travel expenses are minimized. 3. The professional educators used are experts in adult learning. 4. Transfer-of-learning issues are eliminated. 5. The learners are motivated to learn.

1245

The nurse manager is coaching an employee who has been late for work three mornings this week. What statements and questions should the manager include in this coaching session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. What is causing you to be late? 2. When you are late it throws the pace of the entire unit off and client care suffers. 3. Does it not bother you that your lateness makes everyone elses job more difficult? 4. You have been late three times this week and that is not acceptable. 5. What are you going to do to avoid being tardy again?

1245

A nurse manager often uses negative reinforcers as part of operant conditioning in order to inhibit undesirable behaviors. What often results from this action? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The employee ducks into a client room each time the manager is seen. 2. The undesirable behavior vanishes permanently. 3. No improvement in the frequency of the undesired behavior is seen. 4. The employee calls in sick more often. 5. The manager must constantly monitor the situation.

1345

Which findings associated with an employee are likely to be considered when discussing performance? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The employee states, I have to work so that we can have insurance coverage for our disabled child. 2. The employee has been tardy on one occasion when an unexpected snow fell just before shift change. 3. The employee was involved in a motor vehicle accident last fall. 4. The employee found a purse containing $200 in the cafeteria and turned it in to security. 5. The employee made two work errors requiring incident reports in the last year.

245

A hospital uses a results-oriented evaluation system. During a nurses hiring process, the manager states, Once you have been officially hired, I want to meet with you regarding evaluation. What will be the focus of this meeting? 1. The manager will give the nurse a set of work objectives for the next year. 2. The manager will explain how poor evaluations can lead to termination. 3. The nurse and the manager will work together to write work objectives for the nurse. 4. The manager will review the nurses previous job experiences.

3

A manager has been informed by a reliable registered nurse that an assistant lied about bathing a client. The manager calls the assistant into the office with a written warning. Why is this action inappropriate? 1. The registered nurse should issue the warning. 2. The first warning should be verbal. 3. The assistant should be allowed to discuss the matter. 4. This type of action should be conducted by the human resources department.

3

A terminated employee files a grievance against the nurse manager. Which situations would benefit the employees claim? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse manager wrote notes on the expectations discussed during disciplinary sessions. 2. The terminated employees last evaluation discusses problems with performance, but no coaching is described. 3. When problems with the employee arose, the managers average time of intervention was less than 1 day. 4. There are notes in the employees record from human resources indicating the nurse manager had discussed issues with the HR director. 5. In one note, the manager describes the employee as petulant, immature, and uncaring.

25

A hospital has been acquired by a new management company. As part of this acquisition, several different types of equipment have been introduced into the client care area. How can the manager best plan to reduce the stress of using this equipment? 1. Have all the equipment put into service at one time so learning will be compressed. 2. Teach the nurses with the most seniority to use the equipment and let them teach the other nurses. 3. Be certain that all nurses attend training sessions on the use of all equipment. 4. Post written instructions in the break room on how to use the equipment.

3

A nurse executive says, I would really like to develop our current nurses so they can take a greater leadership role in the future. Why is this a good management plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Employees with a long history at the facility are easier to control. 2. This method of developing leaders has proved to be cost-effective. 3. The leadership development can be varied according to the needs of the nurse. 4. When leaders are developed from within, management is already aware of their strengths and weaknesses. 5. The specific needs of the organization can be served

2345

A nurse is being terminated due to continued violation of hospital policy. What statements by the manager are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Your actions have been degrading to the profession. 2. You may wish to resign rather than being terminated. 3. Human resources will answer any questions you may have about benefits. 4. Im sorry you could not be happy here. 5. You are being terminated for the policy violations I have just outlined.

235

A unit secretary is chronically late returning from breaks. The rest of the secretarys work is excellent and he is always helpful and supportive of nurses and client families. The nurse manager has discussed the lateness with him, but it has not stopped. Thinking this might be an attention-seeking behavior, the manager decides to use extinction as a strategy. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Offer the secretary a free lunch if he can go 1 week without being late. 2. Ignore the behavior. 3. Place a large alarm clock in the break room and set it each time the secretary takes a break. 4. Plan to be away from the secretarys area during his break times. 5. Tell the secretary that one more late return will result in a written critical incident report.

24

The hospitals new management company has assigned a leadership coach to groups of current nurse managers. Which statements made by a manager would the coach interpret as indicating the manager does not value this opportunity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Why do I need a coach? 2. Ive been a manager longer than our coach has been a nurse. 3. Im getting burned out with the way we manage. 4. Another new program to waste our time. 5. Coaching has helped my nurses improve their practice.

24

An organization has elected to use a behavior-oriented self-evaluation system for nurses. Which statement would be included on the evaluation form? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Becomes BLS (basic life support) instructor within 1 year of employment 2. Maintains confidentiality of information 3. Achieves certification in specialty 4. Demonstrates care, respect, and compassion in all interactions 5. Works well on multidisciplinary teams

245

The manager has just terminated a nurse. What statement by the manager is appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. You may go back to the unit to say good-bye to your coworkers. 2. We have cleaned out your locker and have your personal belongings ready for you. 3. I have notified security to escort you as you leave the building. 4. As of this time, you are no longer an employee of this institution. 5. Please do not discuss your termination with any other nurses.

34

An organization has begun using critical incidents as part of the evaluation process. The supervisor is meeting with a manager to review the managers use of critical incidents since training last week. Which finding would concern the supervisor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Each nurse has one critical incident recorded and it is positive. 2. The manager is writing these notes in a handheld electronic device. 3. The managers notes are all written at the same time on the same day. 4. There is no indication that the critical incidents recorded have been shared with staff. 5. One note states, This nurse has an abrasive personality.

345

A busy ICU unit has a high noise level. This frustrates the charge nurse in part because it is difficult to focus when entering physicians orders into the electronic medical record. Which would be the most appropriate action by the ICU nurse manager? 1. Decrease the noise level on the unit. 2. Tell the staff members that they need to be quiet when sitting at the nurses station. 3. Close the doors to the clients rooms. 4. Rearrange the space so that an area that is quieter is available for order entry.

4

A nurse manager believes that a staff nurse is rude to clients. In the past year, other nurses and staff from other departments have reported that the nurse has treated them rudely. The manager reviews the staff nurses employee file and finds last years appraisal as exceptional. What is the managers best course of action during this years evaluation? 1. Tell the nurse that complaints about rudeness have been received and that additional complaints will result in termination. 2. Notify nursing administration of the issues and complaints. 3. Tell the nurse that other staff nurses have complained about rudeness and have been instructed to keep a log of incidents. 4. Include documentation of these issues in the evaluation that is discussed with the nurse and provide a plan of action.

4

A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment? 1. Delegation is not taught at all nursing schools. 2. Shift report differs in all hospitals. 3. Shift report and UAP delegation are minimal tasks and good for novice nurses. 4. The manager should focus on those skills specific to the new nurses role.

4

A nurse who had advanced to assistant nurse manager was demoted back to staff nurse last month. The manager gives the nurse low-acuity client assignments. The nurse is efficient, unhappy, and bored. The nurses response is most likely related to which phenomena? 1. Low self-esteem 2. Low morale 3. Mismanagement 4. Underutilization

4

A nurse who transferred from the medical-surgical unit completed orientation to the ICU 6 weeks ago, but is stressed and unsure of personal skill competency. The nurse manager learns of this lack of confidence. Which action by the manager would best benefit this nurse and the unit? 1. Reduce the nurses client assignment. 2. Transfer the nurse back to the medical-surgical unit. 3. Provide written instruction regarding the desired unit specific skills. 4. Provide additional weeks to orientation with a focus on skill development.

4

An ICU nurse manager has been struggling to correct client care issues on the unit and has asked the unit director for assistance. The director says, Training and discipline on your unit is your responsibility. I have other things to do. Now, the manager is faced with disciplining a nurse regarding another client care issue. What is the most significant reason this manager is hesitant to administer this discipline? 1. The nurse may quit. 2. The nursing staff is a cohesive group and might retaliate. 3. The manager is not comfortable with confrontation. 4. The manager does not feel supported by the director.

4

An OB nurse has violated a unit policy. The OB manager is discussing the incident with the nurse. During the discussion the nurse informs the OB manager of the actions of other staff and the physicians attitude leading up to the event. How should the manager address these issues? 1. Tell the nurse that physicians attitude is none of the nurses business. 2. Inform the nurse of the policy violation. 3. Inquire about the physicians attitude and the staff actions during the incident. 4. Redirect the nurse to focus on the issue

4

An experienced nurse often answers less experienced nurses questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify? 1. Clinical colleague 2. Clinical mentor 3. Clinical leader 4. Clinical expert

4

The manager is watchful of compassion fatigue among the nursing staff of the emergency department. What is the best indicator to the manager that this disorder is occurring? 1. Nurses complain of being too tired to work. 2. Clients complain that nurses are not compassionate. 3. Physicians complain that the nurses are not taking good care of clients. 4. Symptoms much like severe burnout occur in the staff.

4

The manager overhears a nurse say to a client, I am having trouble getting your IV started because you are so fat. The manager determines that a critical incident form should be completed. Which entry is appropriate to document on the form? 1. The nurse was rude to the client. 2. The nurse was rude and incompetent when caring for the client. 3. The client is obese, and intravenous catheter placement was attempted but unsuccessful due to the clients size. 4. Nurse _____ attempted to start an IV on this client and stated, Im having trouble getting your IV started because you are so fat.

4

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, They even assigned me a mentor. What is erroneous about this statement? 1. Magnet hospitals do not hire new graduates. 2. Magnet hospitals do not use mentor programs. 3. Mentors are only assigned to experienced nurses. 4. Preceptors are assigned; mentors choose protgs.

4

In the morning care conference, the nurse instructs the assistant to feed breakfast to the clients in beds 2234, 2230, and 2241. The assistant indicates understanding of the assignment and repeats the bed numbers back to the nurse. What is the nurses next step? 1. Check with the assistant to see how the assignment is going during the time breakfast is served. 2. Check the clients breakfast trays before they are returned to dietary. 3. Check with the clients to see if they had breakfast. 4. At the end of the shift ask the assistant how the clients ate.

Correct Answer: 1 Rationale 1: Checking with the assistant while the tasks are being done is the best plan. If there is a misunderstanding or problem, this is the best time for the nurse to intervene. Rationale 2: Simply seeing an empty breakfast tray does not guarantee that the instructions were carried out correctly. Rationale 3: Checking with the clients does not allow for the nurse to amend the instruction or correct the actions being taken. Rationale 4: Waiting until the end of the shift does not allow the nurse to amend the instruction or correct actions being taken.

Question 1 Type: MCSA The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation? 1. Creativity 2. Problem solving 3. Brainstorming 4. Decision making

Correct Answer: 1 Rationale 1: Creativity is a part of the critical-thinking process that fosters the development and implementation of new approaches to different situations. Rationale 2: Problem solving implies there is a problem that needs a solution. Rationale 3: Brainstorming generates diverse ideas with many superficial solutions. Rationale 4: Decision making identifies one effective strategy that is not necessarily innovative.

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration? 1. Are there different situational effects or contexts to be considered? 2. How has the problem usually been handled? 3. What is the easiest and least expensive alternative? 4. Can the problem be solved using the nursing process?

Correct Answer: 1 Rationale 1: Critical thinking involves choosing the best alternative from several, depending on the situation in which the problem occurred. This is the context of the problem. Rationale 2: Handling the problem the way its usually handled may be easy but would not involve critical thinking. Rationale 3: Choosing the easiest or least expensive alternative may be easy but would not involve critical thinking. Rationale 4: The nursing process should be used in critical thinking, but the changing situation is the more defining and specific characteristic of critical thinking.

The nurse manager has planned a meeting that all staff nurses have to attend. Which method would most efficiently notify the staff members of the meeting time? 1. E-mail 2. Voice mail 3. Memo 4. Telephone call

Correct Answer: 1 Rationale 1: E-mail minimizes time wasted trying to contact individuals and the urgency of the message can be coded. Rationale 2: Voice mail is time consuming because the caller must place the call. There is also the possibility the person will answer the call, which entails a greater investment of time. Rationale 3: There is a risk that the memo will be placed where it is not accessible to all staff members. Rationale 4: A telephone call may lead to socializing and small talk, which are time wasters.

The staff nurse is unsure of the correct protocol for calling in sick to work. The nursing supervisor told the nurse to call the nursing office; however, the nurse manager told the nurse to call the unit. This issue is likely the result of which distorted communication? 1. Intersender conflict 2. Intrasender conflict 3. Metacommunication 4. Downward communication

Correct Answer: 1 Rationale 1: Intersender conflict occurs when a person receives two conflicting messages from different sources. Rationale 2: Intrasender conflict occurs when a verbal message differs from the nonverbal message; the recipient has difficulty interpreting the intended meaning. Rationale 3: Metacommunication is the combination of oral messages with nonverbal messages. Rationale 4: Downward communication occurs from manager to staff and is often directive.

The person who has just been promoted to nurse manager is male. If this nurse communicates in a way that is considered typical for men, what can the staff expect? 1. He will focus more on the issue than on personal experience. 2. He will strive to reach consensus within the group. 3. He will strive to avoid conflict within the group. 4. He will prefer to ask questions rather than make statements.

Correct Answer: 1 Rationale 1: Men have been socialized to remain focused on the issue and avoid self-disclosure about personal experiences. Rationale 2: Men can tolerate disagreement within the group. Rationale 3: Men may be more apt to tolerate conflict than women. Rationale 4: Women are more apt to ask questions to seek input.

During an evaluation conference, the nurse manager observes nonverbal messages, including nodding in agreement and smiling. These behaviors are examples of which aspect of communication? 1. Metacommunication 2. Intrasender conflict 3. Fogging 4. Intersender conflict

Correct Answer: 1 Rationale 1: Metacommunications are nonverbal messages conveyed by body language and environmental factors. Rationale 2: Intrasender conflict occurs when there is a difficulty in the interpretation of an intended message due to disparity between verbal and nonverbal communication. Rationale 3: Fogging is a communication technique in which one partially agrees with what was said. Rationale 4: Intersender conflict occurs when there is a difficulty in the interpretation of an intended message due to disparity between different sources.

A novice nurse manager is devising a schedule to meet the needs of the staff, clients, and other disciplines on the unit. Which is the most important method to counteract wasted time in nursing? 1. Delegate routine activities to concentrate on other tasks. 2. Assign a staff member to attend management meetings. 3. Redesign the position so that the nurse manager works when the unit is not busy. 4. Strictly adhere to a rule that the manager will see only staff members who make appointments.

Correct Answer: 1 Rationale 1: One of the most important time wasters in nursing at all levels is failing to delegate tasks that another lower level staff member could do. Rationale 2: Staff should not routinely attend management meetings. Rationale 3: The manager must be available during the busier times on the unit, especially in emergencies. Setting the managers work schedule to avoid these busy times is not appropriate. Rationale 4: Seeing staff only by appointment does not fulfill the job responsibilities of a nurse manager.

The nurse manager has decided to work on personal time-management skills. What should this manager do first? 1. Review patterns of time use. 2. Purchase a new notebook system for time management. 3. Identify essential job activities. 4. Set a goal of prioritizing tasks every morning.

Correct Answer: 1 Rationale 1: The first step is always to assess, so reviewing patterns of time use is correct. Rationale 2: Deciding to purchase a new notebook system for time management is implementing a strategy and is not the first step of the process. Rationale 3: Identifying essential job activities would come second as a result of reviewing patterns of time use. Rationale 4: Setting a goal of prioritizing tasks every morning is a part of planning and is not the first step of the process.

The nurse manager has determined the need to hire two staff nurses. Which factor is most critical as the nurse manager prepares to submit the request to administration? 1. Timing of the request 2. Negative inquiry 3. Compromise 4. Persistence

Correct Answer: 1 Rationale 1: The nurse manager should plan to meet with administration when there is sufficient time and the supervisor seems receptive. Rationale 2: Negative inquiry is used after a request has been denied. Rationale 3: Compromise occurs after a request has been denied. Persistence and repetition are used after a request has been denied. Rationale 4: Persistence and repetition are used after a request has been denied.

A nursing supervisor has a report due and just cannot seem to find the time to get it completed. One day before it is due, the supervisor turns it in. This situation best exemplifies which time waster? 1. The supervisor waited for the deadline pressure to increase the priority. 2. The report was one of the last tasks on the to-do list. 3. The supervisor has no interest in the topic of the report. 4. The report format is unfamiliar to the nursing supervisor.

Correct Answer: 1 Rationale 1: This is a classic example of procrastination, and the manager waited until it absolutely had to be done because of the looming deadline. Rationale 2: Being the last task on the to-do list is a plausible reason for the wait, but is not the most likely reason. Rationale 3: Lack of interest on the supervisors part is a plausible reason for the wait, but is not the most likely reason. Rationale 4: The supervisor could be unfamiliar with the report format, but this is not the most likely reason for the delay.

How can a nurse who is consistently falling behind at work improve to become more organized and disciplined? 1. Use the same system every day to organize client care and required activities such as paperwork. 2. Ask the nurse manager to grant permission for fewer client assignments until more experience with organization is achieved. 3. Ask the unit secretary to do required paperwork to decrease the amount of time required. 4. Practice a shorter client assessment technique to minimize the time required for this activity.

Correct Answer: 1 Rationale 1: Using the same system consistently makes organization a habit. Rationale 2: Asking for a lighter load shifts the load onto other nurses and is not appropriate. Rationale 3: The unit secretary cannot legally do the nurses paperwork. Shifting work onto the unit secretary is not appropriate. Rationale 4: Skimping on client assessment could cause a decrease in client care quality or legal consequences.

A nurse frequently has to work late and has no time to do required training while at work. She has to do it on her days off. Choose the work-related time waster that commonly puts nurses in this position. 1. Unscheduled tasks delaying those that are scheduled 2. An overwhelming amount of work to do 3. Taking longer-than-scheduled breaks 4. Volunteering for extra responsibilities

Correct Answer: 1 Rationale 1: While working with different disciplines, work days are in a constant state of flux, unscheduled tasks and events occur, and sometimes nurses get behind. Rationale 2: While the amount of work can be daunting at times, it is generally not overwhelming consistently if time is managed effectively. Rationale 3: While taking longer breaks does occur, it is not a common reason for having to work late. Rationale 4: Volunteering does occur, but the nurse who is having difficulty keeping up with work days would generally not volunteer for extra responsibilities.

The nurse manager tells the staff that this year's budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information? 1. The budget is a fixed one. 2. The hospital uses incremental budgets. 3. The hospital uses a variable budget. 4. The hospital starts the budgeting process with a zero-based budget.

Correct Answer: 1 Rationale 1: A fixed budget is one in which budgeted amounts are set regardless of changes that occur during the year, such as patient volume or program activities. Rationale 2: An incremental or line-by-line budget lists each expense item or category on a separate expense line. It is not possible to tell from this description if the budget is incremental. Rationale 3: A variable budget is developed with the understanding that adjustments to the budget may be made during the year based on changes in revenue, patient census, utilization of supplies, and other expenses. Rationale 4: A zero-based budget assumes the base for projecting next years budget is zero. It is not possible to tell if the budget being described is a zero-based budget.

Question 19 Type: MCSA A chief nurse officer (CNO) of a rural hospital is meeting with department directors and the human resources officer to discuss the hospitals recruitment strategies. A newly promoted director suggests a recruitment fair at a metropolitan city 100 miles away. The CNO rejects this proposal. Which option is likely the CNOs rationale for this decision? 1. The CNO would prefer to focus on the local area initially. 2. A metropolitan area is not a good area in which to recruit for a rural hospital. 3. Metropolitan nurses skills are too advanced for a rural hospital. 4. The director is new to the role and the CNO does not respect the nurses opinion.

Correct Answer: 1 Rationale 1: A hospital should focus on their local area initially and then extend to other geographical areas. Rationale 2: Rural hospitals do recruit in metropolitan areas but typically focus on the local area as priority. Rationale 3: Metropolitan nurses skills and rural hospital nurses skills are similar. Their client populations are different but rural hospital nurses have similar nursing skills, especially when stabilizing clients for transfer to tertiary hospitals. Rationale 4: There is no indication that the CNO does not respect this director, who may have fresh ideas and new perspective when addressing recruitment.

A nurse has interviewed with the nurse manager for a position and is very interested in obtaining it. After the interview, what would be an appropriate action to take? 1. Call the human resources director the following day regarding the selection process. 2. Call a staff nurse on the unit and inquire whether a decision has been made regarding the candidate. 3. Send a post-interview thank-you letter the following day. 4. Call the interviewer every day postinterview until a decision is announced.

Correct Answer: 3

Question 10 Type: MCSA The hospital is preparing for a tabletop test of its emergency operations plan. What is the potential for an interruption in services from this drill? 1. There is little potential for interruption as the drill is all done in a meeting. 2. There is some potential for interruption of non-client-care services such as billing and scheduling. 3. There will be interruption in some services that generally occupy the area where the enormous table is set up for the drill. 4. Normal services will probably be interrupted by the simulated situations and simulated clients.

Correct Answer: 1 Rationale 1: A tabletop drill occurs when key players in the EOP gather and walk through a drill. Rationale 2: There is no expected interruption in these services. Rationale 3: There is no requirement for an enormous table for this drill. Rationale 4: There are no simulated clients or real scenarios in this drill.

The nurse has just been notified that a client is to be admitted from the emergency department (ED) with a diagnosis of alcohol intoxication. The ED nurse says they have been unable to obtain much history because of the client's lethargic state. Which action is an appropriate intervention by the nurse? 1. Approach the client with caution when obtaining vital signs and shift assessments. 2. Place the client in a room farthest from the nurse's station so as not to disturb other clients. 3. Place the client in four-point restraints as a protective measure. 4. Post an armed security person at the client's door.

Correct Answer: 1 Rationale 1: Alcohol withdrawal clients may lash out in violence. Rationale 2: Placing the client farthest away from the nurse's station may cause added liability to the organization due to the client's lethargic state and potential for harm if not closely monitored. Rationale 3: There is no evidence that it is necessary to place this client is restraints. Rationale 4: There is no evidence that it is necessary to post an armed guard at the door.

Question 25 A nurse manager is interviewing a candidate who has much experience in other industries. The candidate was recently licensed and is interviewing for a registered nurse charge position. Which consideration is most important for the manager to bear in mind when regarding this candidate? 1. Can the candidate perform the job? 2. Will the candidate perform the job? 3. Will the candidate apply past work experience? 4. How long will the candidate retain this position if hired?

Correct Answer: 1 Rationale 1: Although the candidate has past work experience in other industries, it is unlikely that he or she would be able to handle a charge nurse position as an inexperienced nurse. An inexperienced nurse must learn the work environment before performing in a leadership role. Rationale 2: The candidate will probably perform the job to some degree but likely does not have sufficient nursing experience to do the job well. Rationale 3: The candidate will apply his or her previous work experience because it brings knowledge to the job. Rationale 4: How long a candidate will retain a position is uncertain, no matter what his or her qualifications and past work experience.

Question 25 Type: MCSA A nurse manager is interviewing a candidate who has much experience in other industries. The candidate was recently licensed and is interviewing for a registered nurse charge position. Which consideration is most important for the manager to bear in mind when regarding this candidate? 1. Can the candidate perform the job? 2. Will the candidate perform the job? 3. Will the candidate apply past work experience? 4. How long will the candidate retain this position if hired?

Correct Answer: 1 Rationale 1: Although the candidate has past work experience in other industries, it is unlikely that he or she would be able to handle a charge nurse position as an inexperienced nurse. An inexperienced nurse must learn the work environment before performing in a leadership role. Rationale 2: The candidate will probably perform the job to some degree but likely does not have sufficient nursing experience to do the job well. Rationale 3: The candidate will apply his or her previous work experience because it brings knowledge to the job. Rationale 4: How long a candidate will retain a position is uncertain, no matter what his or her qualifications and past work experience.

Question 3 Type: MCSA Nurses in a hospital are working to establish a union. Which finding will these nurses be interested in seeing? 1. Thirty percent of eligible hospital nurses have signed a card indicating interest. 2. Seventy percent of hospital employees have said they are interested. 3. Fifty percent of staff nurses and management nurses must vote. 4. Thirty percent of all nurses working for the agency must vote.

Correct Answer: 1 Rationale 1: Before an election can be held, the union must demonstrate interest by 30 percent of eligible hospital nurses signing an authorization card. Rationale 2: Interest in establishing a union must be demonstrated by those who will be establishing the unionin this case, nurses. Rationale 3: Management nurses are not considered eligible employees when interest in a union is measured. Rationale 4: Eligible employees include staff nurses but not managers and supervisors

Question 7 Type: MCSA Approximately half of an organizations employees decide they are not happy with their current contract, which will expire in 4 months. The union representative informs the group that they can work to change the contract. What is the next step in this process? 1. Giving the union notice of desire to change the contract at least 90 days before it expires 2. Ratification of the current contract 3. Vote for cessation 4. Appointment of a mediator

Correct Answer: 1 Rationale 1: Before changing or terminating a contract, one party must notify the other of its intent to do so 90 days prior to the contract expiration date. Rationale 2: Ratification is the process by which employees approve a contract. Rationale 3: Cessation is not related to union membership. Rationale 4: A mediator is appointed if the two sides of the contract cannot agree on changes.

Question 25 Type: MCSA The National Labor Relations Board (NLRB) has certified a union to be the bargaining agent for a hospital. A nurse working in the hospital has a grievance and says to the nurse manager, Wait until the union gets involved. Which response by the manager is appropriate? 1. NLRB certification does not mean a union will develop. 2. A union will not get involved in this situation. 3. The NLRB is not concerned with your grievance. 4. The grievance will be resolved with or without the NLRB.

Correct Answer: 1 Rationale 1: Certification by the NLRB of a union to be the bargaining agent does not automatically mean employees have a contract. Rationale 2: The manager has no way of knowing if this grievance will be settled by the time the union is in place. Rationale 3: Unions do get involved in grievances. Rationale 4: There is no guarantee that this grievance will be resolved.

A nurse is unsure in which graduate nursing program to enroll. A colleague recommends the nurse consider a degree program for which it appears there will be growing demand. Which role is expected to continue to be in great demand in the future? 1. Nurse administrators 2. Community health nurse 3. Nursing education 4. School nurse

Correct Answer: 3

Question 8 Type: MCSA A hospital has sustained massive destruction after being struck by a tornado. The disaster plan has been activated. The administrator would expect help from which agency to coordinate the disaster efforts? 1. The Federal Emergency Management Agency (FEMA) 2. The Joint Commission 3. The Office of Homeland Security 4. Congress

Correct Answer: 1 Rationale 1: Congress directed FEMA to coordinate disaster efforts. Rationale 2: The Joint Commission does not coordinate disaster efforts, but does ensure that the hospital has a plan. Rationale 3: The Office of Homeland Security would be part of the disaster recovery effort, but would not be the coordinating service. Rationale 4: Congress has designated organizations to coordinate relief efforts, but would not direct those efforts.

A nurse constantly complains about employee policies and procedures and frequently mentions how they are out to get us. The nurse is surprised when referred to by the manager as disgruntled during a discussion of this behavior. What information should the manager provide this nurse? 1. People who are constantly complaining decrease the morale of the rest of the unit. 2. You have complained so long, it will be impossible to change your behavior. 3. Being a complainer is a character trait. 4. Your attitude problem makes everyone else in the unit miserable.

Correct Answer: 1 Rationale 1: Disgruntled, complaining employees adversely affect everyone else's morale. Rationale 2: Complaining is a behavior and it can be changed with time, work, and coaching. Rationale 3: Complaining is a learned behavior and can be unlearned. Rationale 4: Complaining is not an attitude problem as much as a learned behavior.

The nurse manager identified that the census was higher than anticipated and the client acuity level was also high; however, there were fewer nursing hours paid. This variance is an example of which budgetary variance? 1. Efficiency 2. Nonsalary expenditure 3. Rate 4. Volume

Correct Answer: 1 Rationale 1: Efficiency variance is a reflection of the difference between budgeted and actual nursing care hours provided. Rationale 2: Nonsalary expenditure variance is a deviation from the budget as a result of changes in client volume, supply quantities, or prices paid. Rationale 3: Rate variance is the difference between budgeted and actual hourly rates paid. Rationale 4: Volume variances are the differences in the budget as a result of increases or decreases in patient volume.

Question 25 Type: MCSA Hospital administration is aware that staff may be reluctant to be called back to work in a disaster. How can the hospital be proactive in encouraging staff to make the decision to serve? 1. Develop a caring relationship with staff during normal times. 2. Develop a pay scale that offers double pay for all those who work during disasters. 3. Offer additional time off to those who work during a disaster. 4. Focus on the skills advancement opportunities that occur when working in a disaster.

Correct Answer: 1 Rationale 1: If staff members have a caring relationship and feel ownership of the hospital, they are more likely to respond in an emergency. Rationale 2: Salary may not be a big enough incentive for those who are reluctant to leave family during a disaster. Rationale 3: Time off in the future is not likely to be enough incentive to attract staff into a disaster situation. Rationale 4: The opportunity to advance skills is not likely to attract many staff members back to work in a disaster.

Question 8 A candidate has arrived for an interview. The interview is conducted with various personnel within the organization. This is an example of an attempt to ensure which result? 1. Interrater reliability 2. Intrarater reliability 3. Validity 4. Construct validity

Correct Answer: 1 Rationale 1: Interrater reliability is agreement between two interviews of the same candidate by several interviewers. Rationale 2: Intrarater reliability is agreement between two interviews of the same candidate by the same interviewer. Rationale 3: Validity is the ability to predict job performance. Rationale 4: Construct validity means the standardized interview questions will accurately predict job performance.

Question 8 Type: MCSA A candidate has arrived for an interview. The interview is conducted with various personnel within the organization. This is an example of an attempt to ensure which result? 1. Interrater reliability 2. Intrarater reliability 3. Validity 4. Construct validity

Correct Answer: 1 Rationale 1: Interrater reliability is agreement between two interviews of the same candidate by several interviewers. Rationale 2: Intrarater reliability is agreement between two interviews of the same candidate by the same interviewer. Rationale 3: Validity is the ability to predict job performance. Rationale 4: Construct validity means the standardized interview questions will accurately predict job performance.

Question 2 Type: MCSA When the unit manager is on vacation, the charge nurse fills in the leadership role. While in this role the charge nurse senses a change in the nursing staffs morale. The staff appears happier, more energetic, and productive. The charge nurse believes this change is a direct effect of which variable? 1. The staffs relationship with the nurse manager 2. The environment of the organization 3. Level of compensation 4. The shifts they are working

Correct Answer: 1 Rationale 1: Job satisfaction is affected by various facets, one of them being the relationship with the nurse manager. Rationale 2: The overall environment has not changed. Rationale 3: The level of compensation has not changed. Rationale 4: It is unlikely that the substitute manager has changed the shifts nurses are working.

Question 26 Type: MCSA A nurse manager writes the following note: Over personnel budget by $1,250 in April due to late snowstorm. Nurses unable to get to work. Overtime wages paid. Why is this note important? 1. It will help the manager create the budget for the next year. 2. It is required by The Joint Commission. 3. All variances must be documented and forwarded to the hospital attorney. 4. It ensures that there is no question of diversion of hospital funds.

Correct Answer: 1 Rationale 1: Keeping notes regarding variances is a key way of preparing for the next budget cycle. Rationale 2: This is not a Joint Commission requirement. Rationale 3: A budgetary variance is not the same as a client care variance. Rationale 4: These notes are not kept as evidence disputing diversion of hospital funds.

Question 20 Type: MCSA Every month the chief financial officer (CFO) reviews the budget with the hospital's board of directors. The CFO requests a million dollars to purchase a new MRI (magnetic response imaging) unit for the radiology department. Which category best describes this request? 1. Non-revenue expense 2. Capital expense 3. Variable cost 4. Allocation of funds

Correct Answer: 2 Rationale 1: An MRI machine would be revenue producing. Rationale 2: A capital expense is an expense that is above a set dollar amount such as $10,000 and that must be approved by the board of directors. Rationale 3: The cost of this machine is not variable. Rationale 4: Allocation of funds is not specific to the type of budgetary expenditure.

The chief nurse officer (CNO) has received numerous complaints by staff regarding their manager. The staff describes behaviors such as not granting requested days off, favoring other staff members, and allowing lateral violence in the department. Which statement by the CNO to the manager would specifically describe a lack of civility? 1. Your behavior is rude and disrespectful towards your staff. 2. This behavior is unprofessional. 3. This behavior is unacceptable. 4. This behavior warrants a written warning.

Correct Answer: 1 Rationale 1: Lack of civility is rude, disrespectful, and impolite behavior. Rationale 2: This behavior is unprofessional, but this term is not the most specific one provided. Rationale 3: This behavior is unacceptable, but this term is not the most specific one provided. Rationale 4: This behavior likely does warrant a written warning, but this is not the statement that most specifically describes the behavior.

Question 22 Type: MCSA An organization has not updated its sick day policy in the last 5 years and has experienced an increase in employee days off for illness over the last year. Which change to the sick leave policy might have a positive effect on the organizations absenteeism? 1. Change the policy to award personal use days rather than sick days. 2. Place stricter limits on the number of sick days that can be accrued. 3. Limit the amount of sick time an employee can use each year regardless of the amount accrued. 4. Allow employees to trade sick time for money no matter how many hours are accrued.

Correct Answer: 1 Rationale 1: Personal use days are days that the employee can schedule for any use or can use in time of sickness. When the days are designated as personal use days, the employee does not have to be deceitful when using a day for personal time rather than when sick. Rationale 2: When the number of sick days is limited, employees tend to use days to avoid losing the benefit. Rationale 3: Limiting the amount of sick time an employee can use would work as a disadvantage to loyal employees who happen to have an extended illness. Rationale 4: Allowing employees to trade sick time for money would be an unmanageable strain on the budget. Employees might trade in all sick time and then become ill and not have a sick time bank.

Question 24 Type: MCSA An emergency department (ED) manager interviews and hires a candidate who reports having several years of ED experience. Soon after hire, the nurse makes a series of errors and harms several clients. When investigating these errors, the nurse manager discovers the nurse falsified his experience and credentials. Is the hospital liable for this nurses actions? 1. Yes, the hospital could be liable for negligent hiring if credentials were not checked. 2. Yes, the hospital could be liable but only if it did not properly train the nurse. 3. No, the nurse is liable because information about experience was falsified in the interview. 4. Yes, the hospital is liable for all errors committed by nursing staff.

Correct Answer: 1 Rationale 1: The hospital could be liable for negligent hiring if the nurses credentials and experience were not checked. Rationale 2: The hospital is responsible for properly training all newly hired nurses, but in this case the falsified experience and credentials are a more relevant issue. Rationale 3: The nurse could also be liable, but the hospital probably will be found at fault as well. Rationale 4: Hospitals are not always liable for all errors committed by nursing staff if the staff is not following written policy and procedure.

Question 8 Type: MCSA The nurse manager of a critical care unit creates the operating budget with the knowledge that a minimum of two professional nurses must be paid per shift regardless of the patient census. Which group determines this standard? 1. Hospital administration 2. Nursing administration of the hospital 3. The Joint Commission 4. Nursing personnel of the special care units

Correct Answer: 1 Rationale 1: The hospital makes the final determination of which staffing ratios are considered safe for their units. This determination may be made with the input of nursing administration and nursing personnel, but the final determination becomes an institutional policy. Rationale 2: This determination may be made with the input of nursing administration and nursing personnel, but the final determination becomes an institutional policy. Rationale 3: The Joint Commission assures that the institution is following its own policies. Rationale 4: This determination may be made with the input of nursing administration and nursing personnel, but the final determination becomes an institutional policy.

Question 11 Type: MCSA The hospital is conducting a drill of its emergency operations plan (EOP). A nurse is acting as triage officer. Which client would be triaged for immediate care? 1. A client with a minor forearm laceration that will require a simple bandage and tetanus immunization 2. A child with a severe, penetrating head wound 3. A man complaining of chest pain that radiates to his jaw 4. A woman with a compound fracture of the femur

Correct Answer: 1 Rationale 1: The least serious people are seen first in a disaster. Rationale 2: This child is unlikely to survive and would be triaged as last. Rationale 3: This client may be having a myocardial infarction, but would not be triaged as high as another client. Rationale 4: A compound fracture is complicated and therefore this client would be triaged later than another client.

Question 30 Type: MCSA The manager senses that a nurse is very anxious at the beginning of the performance interview. How should the manager proceed? 1. I have looked back over all of my notes and interactions with you to prepare for our interview. 2. I sense that you are very tense. Is there a reason you feel this way? 3. You are so tense! How about a cup of coffee to relax. 4. How are your children? Are you planning anything fun this summer with them?

Correct Answer: 1 Rationale 1: The manager should calmly start the interview, ignoring the nurses tension, which will likely pass as the interview continues. Rationale 2: Drawing attention to the nurses feelings in this manner would not serve to ease the tension. Rationale 3: The manager should not draw attention to the fact that the nurse is tense. Rationale 4: The fact that the interview is going to happen will not be changed by social chit-chat and the nurse will still be nervous.

The supervisor of critical care services tells the unit manager, We must cut costs, so I am asking you to arrange your day so that you provide care to two or three clients and cover for lunch and rest breaks. Also dont forget that your budget estimates are due next week, as are your preliminary schedules for the winter holidays. Two days later, the nurse manager is stressed and exhausted. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Think through the roles being required. 2. Confront the supervisor and ask for clarification of status. 3. Try to improve work organization. 4. Tell the supervisor, I cant work this hard, Get someone else to be manager. 5. Call in sick for a day to rest.

Correct Answer: 1,2

Question 18 A medical intensive care unit has a registered nurse position open. The qualifications for the position require a minimum of 1 year of acute-care nursing experience, BLS and ACLS certification, and the ability to administer intravenous cardiac drips. Which fact in an applicant's application would be sufficient reason to decline the applicants request for an interview? 1. The candidate graduated from nursing school 9 months ago. 2. The candidate does not have ACLS certification. 3. The candidate does not have experience with cardiac drips. 4. The candidate was an LPN for 10 years prior to being an RN.

Correct Answer: 1 Rationale 1: The only criterion that cannot be quickly met through education is length of experience. Rationale 2: ACLS certification can be obtained if the candidate is a good match for the position otherwise. Rationale 3: The ability to administer cardiac drips can be obtained through education if the candidate is a good match for the position otherwise. Rationale 4: The fact that the candidate was previously an LPN is not pertinent to this decision.

Question 18 Type: MCSA A medical intensive care unit has a registered nurse position open. The qualifications for the position require a minimum of 1 year of acute-care nursing experience, BLS and ACLS certification, and the ability to administer intravenous cardiac drips. Which fact in an applicants application would be sufficient reason to decline the applicants request for an interview? 1. The candidate graduated from nursing school 9 months ago. 2. The candidate does not have ACLS certification. 3. The candidate does not have experience with cardiac drips. 4. The candidate was an LPN for 10 years prior to being an RN.

Correct Answer: 1 Rationale 1: The only criterion that cannot be quickly met through education is length of experience. Rationale 2: ACLS certification can be obtained if the candidate is a good match for the position otherwise. Rationale 3: The ability to administer cardiac drips can be obtained through education if the candidate is a good match for the position otherwise. Rationale 4: The fact that the candidate was previously an LPN is not pertinent to this decision.

Question 5 Type: MCSA The nurse managers goal is to adequately staff the unit and use minimal supplementary staff. The manager has added the cost of this supplementary staff to the unit's operating budget. A colleague informs the manager it should have been added to which budget? 1. The personnel budget 2. The operating budget 3. The revenue budget 4. The fixed budget

Correct Answer: 1 Rationale 1: The personnel budget projects the salary costs that will be paid and charged to the cost center in the budget period. Rationale 2: The operating budget is the organizations statement of expected revenues and expenses for the coming year. Rationale 3: The revenue budget represents the patient care income expected for the budget period. Rationale 4: Because the salary cost of supplementary staff is an unknown, the costs are variable, not fixed.

Question 30 Type: MCSA A hospital administrator initiated the emergency operations plan (EOP) after being notified that a tornado struck a nearby community. Thirty minutes later law enforcement calls to report that while significant damage was done, there were only minor injuries. What should the administrator do now? 1. Follow the EOP to deactivate the plan. 2. Let the plan continue for another hour to ensure that no victims arrive. 3. Call the emergency department and tell the staff that the plan is discontinued. 4. Notify local media that the EOP was discontinued.

Correct Answer: 1 Rationale 1: There should be specific information in the EOP to deactivate the plan. Rationale 2: Instituting this plan is expensive and is an imposition on many employees. It should not be used if not needed. Rationale 3: Unless this is the protocol established in the EOP, just calling the emergency department is not sufficient. Rationale 4: There is no reason to notify the local media.

Question 16 Type: MCSA Multiple casualties have arrived at the emergency department following a tornado. Which instruction from the manager to staff is incorrect? 1. There is no time to worry about using personal protective equipment, just try to be safe. 2. Be aware that some of these victims may have been exposed to hazardous substances. 3. Dont let client safety considerations be lost in all of the activity. 4. Feel free to use isolation techniques if required.

Correct Answer: 1 Rationale 1: This is an essential time to use personal protective equipment. Rationale 2: In a tornado, many structures are damaged or destroyed, including those housing hazardous chemicals. The victims may have been exposed to those substances. Rationale 3: Client safety must continue to be an important consideration. Rationale 4: Some clients may require isolation and these techniques should be used if necessary.

Question 13 Type: MCSA A nurse manager has provided education to emergency department nurses regarding disaster management. Which statement would the manager interpret as indicating understanding of this education? 1. We should treat as many clients as possible as quickly as possible. 2. Quick separation of any victim with bleeding wounds from those who are not bleeding is essential. 3. Our goal is to treat those with serious injuries first. 4. We should send those with less serious injuries home without treatment.

Correct Answer: 1 Rationale 1: This is the goal of emergency treatment in a disaster. Rationale 2: There is no indication to take the time to do this separation. Rationale 3: In a disaster those with minor injuries are treated first. Rationale 4: There is no indication that clients would be sent home without treatment.

Question 3 Type: MCSA A nurse is frequently absent on Fridays. The nurse phones and reports as sick, but the manager discovers that the absences are due to child care issues. How should the manager document this on the critical incident form? 1. Voluntary absence on multiple Fridays due to child care issues 2. Absence frequency on Fridays 3. Total time lost includes Fridays 4. Involuntarily absent due to family circumstances

Correct Answer: 1 Rationale 1: Voluntary absenteeism is not coming to work due to a problem that is under the employees control. Child care problems are under the employees control. Rationale 2: Absence frequency is the total number of distinct absence periods that an employee has been absence and is not tied to a specific day. Rationale 3: The fact that Friday is included in the total time lost is not significant. Rationale 4: Involuntary absence is due to something outside the employees control such as illness.

A nurse knows that both experiences and a plan are important when building a rsum. Which attributes are the most important for the plan part of this endeavor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Flexibility 2. Long term 3. Focused on one career path 4. Includes frequent contact with the nurses current mentor through the years 5. Designed around a fixed retirement date

Correct Answer: 1,2

A nurse manager is aware that there is a strong grapevine communication system on the unit. The manager elects to use this grapevine to distribute information about an upcoming change in unit policy. In making this decision, the manager should consider which possibilities? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The information may be rapidly disseminated. 2. The information may be altered as it moves across the grapevine. 3. Most people try to spread information accurately. 4. Most people do not pay any attention to the grapevine. 5. Professional nurses do not participate in grapevine communication.

Correct Answer: 1,2 Rationale 1: Grapevine communication is often rapid and complete. Rationale 2: Grapevine communication is often altered as is goes from person to person. Rationale 3: The grapevine is very prone to distortionsometimes significant distortion. Rationale 4: Most people do believe or at least attend to the grapevine. Rationale 5: Grapevine communication crosses all levels of professionalism.

Which directions given by the nurse to the assistant are most likely to be understood and completed correctly? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Here are your directions for this morning. Please give the clients in rooms 2156, 2158, and 2159 total bed baths. 2. Go to the diet kitchen and get a cup of apple juice for the client in room 2112. 3. Ambulate the clients on the south wing. 4. Do you think youll have time to do shampoos today? 5. It might be a good idea to get the client in room 2110 up in the chair this morning. Or maybe it would be better to wait until this afternoon.

Correct Answer: 1,2 Rationale 1: Saying Here are your directions alerts the assistant that an important statement is going to be made. The instructions are clear and concise. Rationale 2: This is a clear and concise set of instructions. Rationale 3: This direction is not clear. Does the nurse want the clients whose rooms are on the south wing ambulated? Or does the nurse want all ambulation to occur on the south wing today? Rationale 4: This instruction is ambiguous. If the nurse would like for certain clients to have their hair shampooed today, the nurse should indicate that more clearly. Rationale 5: The nurse should be clear regarding what should be done before instruction is provided. Global Rationale:

A nurse manager approaches the nursing supervisor with a request for approval to incorporate 12-hour shifts into scheduling. The supervisor denies the request, stating this staffing pattern was used previously with poor outcomes. Which responses by the nurse manager may positively influence the supervisor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I agree it was not effective years ago, but other units have now had success with it. 2. What were your specific concerns about the 12-hour shifts? 3. I think it is unfair to refuse my unit this opportunity based on the past. 4. Why are you always so opposed to change on my unit? 5. If we dont offer alternative staffing patterns, we arent going to be able to attract new hires.

Correct Answer: 1,2 Rationale 1: This is an example of using fogging, or agreeing with part of what is said. This technique may make the supervisor rethink the decision by offering some new information. Rationale 2: Asking about previous concerns is a type of negative inquiry. It helps the nurse manager understand the supervisors position, but also requires the supervisor to rethink the issue. Rationale 3: Telling the supervisor it is unfair is the same as calling the supervisor unfair and is confrontational. Rationale 4: This approach is confrontational. Rationale 5: Threats, even veiled threats, are confrontational and should not be used.

Question 28 Type: MCMA An unfavorable rate variance has occurred in the salary budget of a unit. When investigating this variance, the nurse manager should look for which situations? Standard Text: Select all that apply. 1. Were any unexpected bonuses awarded? 2. Did agency personnel hours exceed the number predicted in the budget? 3. Were new employees hired at lower wages? 4. Did the number of client days exceed the predicted budgeted amount? 5. Were fewer nursing hours worked than were predicted?

Correct Answer: 1,2 Rationale 1: An expected bonus that was not budgeted could result in an unfavorable rate variance. Rationale 2: Agency personnel hours are higher than hospital employee hours. If the number of hours exceeded the budgeted amount, an unfavorable rate variance would occur. Rationale 3: If new employees are hired at work hours at a lower rate than that of other employees, a favorable rate variance would occur. Rationale 4: Client day variations result in volume variances, not rate variances. Rationale 5: Fewer nursing hours worked would result in an efficiency variance, not a rate variance.

Two nurses are in the day room when a visitor approaches and starts yelling about the care his mother is receiving. One nurse says, I'm sorry you are upset. What can I do for you? The visitor continues to complain more loudly. What should the other nurse do? Standard Text: Select all that apply. 1. Quietly direct other people out of the room. 2. Leave the room and call security. 3. Say, who are you? 4. Move toward the visitor and say, Keep your voice down. 5. Stay next to the other nurse.

Correct Answer: 1,2 Rationale 1: Isolating a person who is angry and aggressive helps by taking away part of the audience. This is also a strategy to protect others. Rationale 2: It may be that the visitor is just upset and will calm down quickly with the other nurse's verbal intervention, but that is not assured. Rationale 3: This question may further infuriate the visitor because the nurses don't know him or his mother. Also, one nurse should carry the conversation. Rationale 4: The nurse should not make a move toward the visitor or demean him. Rationale 5: The nurse should move away and out of the room to call security.

Question 9 Type: MCMA A nurse has been hired as a new nurse manager at a hospital that has union representation. Which union-related activities should this manager expect will be included in the role? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Actively helping to administer any grievance procedures 2. Participating in issues related to disciplining employees 3. Encouraging union membership 4. Being certain that all disputes within management are public 5. Avoiding collective bargaining

Correct Answer: 1,2 Rationale 1: The nurse manager should help to administer grievance procedures and should participate in issues about disciplining employees. Rationale 2: The nurse manager should help to administer grievance procedures and should participate in issues about disciplining employees. Rationale 3: The nurse manager should not encourage or discourage union membership. Rationale 4: Disputes within management should be confidential. Rationale 5: The nurse manager must participate in the activities of collective bargaining.

Part of the facilitys performance evaluation is based on the nurses strength in the three types of decisions. During a nurse managers performance evaluation the supervisor says, You are very good at adaptive decisions, but you need to be more precise in routine decisions. When the situation calls for really innovative decisions, you do not seem sure of yourself. How should the manager interpret this information? Standard Text: Select all that apply. 1. I am not following the policies and rules well. 2. I should review the procedure manual. 3. Im good at using my previous experiences to guide my decisions. 4. I am strongest in making decisions when the problems are very unusual or unclear. 5. I make good decisions when the situation is novel.

Correct Answer: 1,2,3 Rationale 1: Routine decisions are based on policies and rules. Rationale 2: Routine decisions are based on procedures. Rationale 3: Adaptive decisions are often modifications of well-known problems or solutions. Rationale 4: Solving unusual or unclear problems requires innovative decision making. Rationale 5: Novel situations require innovative decision-making abilities.

Which statements by a nurse in the emergency department are examples of groupthink? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Weve already talked about this enough. We need to present a united front on this issue. 2. The medical unit nurses wont like this decision because it is too much work. 3. Lets all vote yes on this so we can get back to work. 4. We need to consider the workload of the intensive care unit nurses. 5. Does anyone else have any ideas to discuss?

Correct Answer: 1,2,3 Rationale 1: Suppression of dissent and new ideas occurs with groupthink. Rationale 2: Stereotyping outsiders is a symptom of groupthink. Rationale 3: There is a strong tendency in groupthink to seek concurrence. Rationale 4: Considering the opinion of others is not a symptom of groupthink. Rationale 5: Leadership controls the discussion and numbers of topics to be discussed in groupthink.

A nurse manager has felt overwhelmed by work the last few months. After putting in many hours of unpaid overtime, the workload is beginning to stabilize. The nursing supervisor asks the manager to take on a new task that is exciting and stimulating. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Consider how much work will be added to the current workload. 2. Tell the supervisor no. 3. Talk with the supervisor about decreasing another work responsibility if this project is accepted. 4. Accept the assignment and plan to continue to work very hard until it is completed. 5. Accept the assignment, but only if additional salary is offered.

Correct Answer: 1,2,3 Rationale 1: The manager must be realistic about how much work can be done. Rationale 2: If the project is too much for the manager to take on, the manager should say no. The manager must be aware of the consequences of declining the assignment. Rationale 3: If the manager would like to take on the new project, it may be necessary to decrease another job responsibility. The manager should discuss this possibility with the supervisor. Rationale 4: The manager should be aware of the consequences of overloading ones self. Accepting the assignment and continuing the current work pace may be dangerous to the manager and to others. Rationale 5: Additional salary does not make additional time. If the nurse does not have sufficient time to commit to the project, additional salary will not be helpful.

Question 14 Type: MCMA The management staff is investigating ways to decrease absenteeism that will also help to promote greater job satisfaction over the long term. Which suggestions should they consider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. We could convert a specified number of unused sick days to vacation days. 2. Is there a way we could convert unused sick time to retirement credit? 3. I think we should stop putting a limit on how many sick days an employee can accumulate. 4. We should think up some penalty for using more than a given number of sick days in a year. 5. I think we should stay with our policy of taking away holiday time if the employee uses a sick day in the same week.

Correct Answer: 1,2,3 Rationale 1: Conversion of unused sick days to vacation days eliminates the feeling that employees are going to lose sick days, which they consider a benefit. Rationale 2: Converting unused sick time to retirement credit helps to eliminate the feeling that employees are going to lose sick days, which they consider a benefit. Rationale 3: When there is a limit on how many sick days can be accumulated, the employee may feel that a benefit has been taken away and may take unneeded sick days to prevent losing that benefit. Rationale 4: Penalties may work to discourage the use of sick time, but will not promote job satisfaction. Rationale 5: A policy of taking away holiday time based on a sick day being taken is punitive to good employees. It may also encourage an employee to come to work when sick. It is not a good way to promote job satisfaction.

Question 22 Type: MCMA A hospital administrator receives a call that mass casualty shootings have occurred at several different locations within the city. Early information indicates that up to 50 victims may be arriving at the hospital starting within minutes. What action should the administrator take? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Mobilize the hospital incident command system. 2. Notify other administrators and order a rapid needs assessment in all critical areas. 3. Authorize the implementation of the hospitals disaster plan. 4. Call the emergency department and ask the charge nurse if the department has received any clients. 5. Conduct a risk assessment to see if the hospital is vulnerable to attack.

Correct Answer: 1,2,3 Rationale 1: This is a disaster situation and incident command is essential. Rationale 2: A rapid needs assessment is essential so that quick action can be taken to fill as many of those needs as possible. Rationale 3: The administrator must be proactive in initiating the disaster plan. Rationale 4: If this is a real disaster, it is unlikely that the charge nurse has time to come to the phone. Rationale 5: This risk assessment should have already been done.

Several months ago, the nurse accepted a management position in the neurological care unit. The nurse has been very challenged and stressed and is unsure the position change was the correct choice. What should the nurse do now? 1. Give proper notice and go back to the previous position. 2. Discuss the matter with the director of the unit. 3. Discuss the matter with staff nurses on the unit. 4. Take a few days off to think about the situation.

Correct Answer: 2

Question 7 A medical unit nurse manager is conducting an interview of a potential employee. Which strategy should the manager use? 1. Document first impressions of the applicant. 2. Review the resume during the interview. 3. Use closed questions to elicit more information. 4. Use work sample questions to determine knowledge.

Correct Answer: 4

Question 19 Type: MCMA A hospitals disaster management team is reviewing the disaster plan after reading about a hospital that was destroyed by a tornados direct hit. What questions should team members ask themselves? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. What are our current capabilities for evacuation? 2. Do we have sufficient resources in any other areas to continue operations if this happens to us? 3. Are there physical training needs that we have not filled? 4. What education should we provide to the staff and community? 5. Would we eventually rebuild if the hospital was destroyed?

Correct Answer: 1,2,3,4 Rationale 1: Evacuation of clients, visitors, and staff should be of primary interest to this team. Rationale 2: The team should consider its resources. What would happen if the hospital campus was damaged? Where are other resources available? Rationale 3: Training for a disaster is essential. Rationale 4: Education about disasters and training for a disaster are two different topics. Training involves physical skills as well as learning. Rationale 5: This is a valid question, but is outside the scope of a disaster plan.

Question 15 Type: MCMA An emergency department has been notified that hundreds of injuries have occurred following the collapse of bleachers at a football game. The emergency department nurses should prepare to make which types of assessments? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Physical 2. Self 3. Situational 4. Family 5. Community

Correct Answer: 1,2,3,4 Rationale 1: Physical assessment skills will be necessary as victims injuries are assessed. Rationale 2: The nurse must be able to conduct a self-assessment of abilities to manage a victim and of personal reaction to the disaster. Rationale 3: The nurse must be making situational assessments at all times during the disaster to ensure a flow of clients, equipment, personnel, and information. The nurse must also assess the safety of the situation. Rationale 4: Victim families are also involved in the disaster. The nurse must assess the families coping abilities. Rationale 5: The nurse will not be involved in community assessment at the time of the disaster, but may be called on for this skill in the days and weeks to follow.

As part of a presentation on health care workplace violence, the speaker says, Injuries to nurses from violent acts in the workplace are probably underreported. What rationale should the speaker offer for this statement? Standard Text: Select all that apply. 1. Nurses may not clearly understand what constitutes workplace violence. 2. Nurses may be unaware of how to report violent actions. 3. Nurses may feel that dealing with violence is an expected part of the job. 4. Nurses may believe that reporting a violent act will mark them as a weak employee. 5. Most violence against nurses is initiated by physicians, and nurses are afraid to report them.

Correct Answer: 1,2,3,4 Rationale 1: The definition of workplace violence may not be clear. Rationale 2: Reporting policies may not be in place. Rationale 3: For many years, violence was tolerated in health care. Rationale 4: Some believe that being the target of a violent act is the result of poor job performance. Rationale 5: Most violence against nurses is from clients.

What are reasons that nurses fail to manage time effectively? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Nurses do tasks they enjoy doing before the ones they do not enjoy. 2. Nurses do things that bring the most immediate closure first. 3. Nurses respond on the basis of who wants something. 4. Nurses do uninteresting jobs before interesting jobs. 5. Nurses work on things in the order of their arrival.

Correct Answer: 1,2,3,5 Rationale 1: Nurses are like anyone else in that they tend to do things they enjoy before they do things they do not enjoy. Rationale 2: Nurses (and others) often do those things that they can get done most quickly first. They feel satisfaction with having one thing done and out of the way. Rationale 3: Nurses tend to prioritize based on who wants something donefor example, if a client wants something that is a priority over the nurse manager needing a report. Rationale 4: It is generally more time efficient to tackle uninteresting jobs first and get them completed before starting interesting jobs that may absorb more of the nurses time. Uninteresting jobs are likely to be completed as quickly as possible. However, it is not human nature to do what is not interesting first. Rationale 5: Nurses tend to work on things as they come up and often end up working on unplanned tasks before planned tasks. This is related to the unpredictable nature of working with people who are ill.

A nurse who has just returned from two weeks of time off following minor surgery says, Im so glad to be back to work. Im sick of watching television. I cant believe I missed the stress here. What are possible explanations for this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Lack of stress can cause boredom. 2. Stress can be motivational. 3. Apathy can occur if stress is absent. 4. Eustress occurs when stress is decreased too much. 5. A balance between stress and coping is essential.

Correct Answer: 1,2,3,5 Rationale 1: A certain amount of stress is stimulating. Without stress boredom can occur. Rationale 2: A moderate amount of stress can motivate a person to perform. Rationale 3: A person who is accustomed to stress may become apathetic if stress is removed. Rationale 4: Eustress is positive stress. Rationale 5: If there is not enough stress, the person feels out of balance.

Question 22 Type: MCMA The budget committee of a hospital is holding the first meeting of the budgetary cycle in two weeks. The finance department is preparing an information packet to be distributed to members. What statistical information should be included? Standard Text: Select all that apply. 1. The average daily census for the facility over the last year 2. Current community wage ranges for employee classifications 3. Changes in accrediting body or legislative regulations 4. Number of nurses terminated for cause over the last year 5. Current staff mix across the hospital

Correct Answer: 1,2,3,5 Rationale 1: Average daily census will be valuable information in developing this years budget. Rationale 2: Wage ranges in the market are critical information for the budget committee. Rationale 3: Regulation changes often result in an increase in cost. Rationale 4: Information regarding number of nurses terminated for cause will not be helpful to the budgeting committee. Rationale 5: Staff mix for all departments is necessary for this committee.

The nurse appears in the nursing station with multiple facial lacerations and says, A visitor hit me. What is the managers priority action? 1. Ask the nurse why the visitor became violent. 2. Ask a nurse to accompany the employee to the emergency department. 3. Call security to report the incident. 4. Call administration and inform them of the incident.

Correct Answer: 2

Question 17 The manager has determined that a nurse is marginal, but elects to ignore the situation for now, hoping the nurses work will improve. What risks has the manager taken by choosing this strategy? Standard Text: Select all that apply. 1. The nurse may harm a client. 2. Other nurses on the unit may become disgruntled by having to cover for this nurse. 3. The nurse may never become a good employee. 4. The manager may be terminated. 5. The morale of the unit may decline.

Correct Answer: 1,2,3,5 Rationale 1: Marginal work may result in harm to clients. Rationale 2: A marginal employee increases the workload on other, more competent employees. Rationale 3: If marginal work is allowed to continue, the nurse may never change. Rationale 4: It is unlikely that a manager would be terminated because of one marginal employee. Rationale 5: Having a marginal employee who must be constantly coached and watched may negatively affect the morale of other staff and the entire unit.

Question 21 Type: MCMA A nurse manager has recently been transferred from obstetrics to pediatrics. The manager consistently stays in the office, does not relieve staff for lunches, and rarely assists staff when the unit is busy. Lately, the manager has noticed an increase in staff absences. Which options may contribute to the situation on this unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The manager has a lack of confidence in personal ability to provide care to pediatric clients. 2. The manager is unable to confront staff regarding absences. 3. The manger is not supervising the work of the unit. 4. The staff is consciously taking advantage of the manager. 5. The manager has a lax attitude toward absenteeism.

Correct Answer: 1,2,3,5 Rationale 1: The manager just transferred from a different unit and may be uncomfortable with skills needed to care for pediatric clients. Rationale 2: Confronting the staff about absences may be difficult for a new manager. Rationale 3: If the manager consistently stays in the office, supervision is minimal. Rationale 4: It is difficult to say that the staff is consciously taking advantage of the manager, but this may be occurring on a subconscious level. Rationale 5: The managers own absence culture may be very tolerant.

Question 28 A nurse manager lists several preferences for hiring employees. The human resources manager would advise this manager that which practices do not meet the bona fide occupational qualification (BFOQ) regulation? Standard Text: Select all that apply. 1. I like to hire all female nurses to work in labor and delivery and postpartum. 2. I hire only strong young men as transport workers. 3. I prefer to hire nurses who have served in the military. 4. I only hire nurses who are bilingual for work in the emergency department. 5. I prefer to hire women as unit clerks.

Correct Answer: 1,2,3,5 Rationale 1: There is no legal reason to hire only females in labor and delivery and postpartum. Rationale 2: There is no reason an older male or a female could not be hired as a transporter. Rationale 3: It is not legal to ask questions regarding military service prior to hire. Rationale 4: Being bilingual is a qualification necessary for work in some emergency departments. The nurse could not hire based on national origin, just on the basis of speaking more than one language. Rationale 5: There is no reason a man could not be successful as a unit clerk.

Question 28 Type: MCMA A nurse manager lists several preferences for hiring employees. The human resources manager would advise this manager that which practices do not meet the bona fide occupational qualification (BFOQ) regulation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I like to hire all female nurses to work in labor and delivery and postpartum. 2. I hire only strong young men as transport workers. 3. I prefer to hire nurses who have served in the military. 4. I only hire nurses who are bilingual for work in the emergency department. 5. I prefer to hire women as unit clerks.

Correct Answer: 1,2,3,5 Rationale 1: There is no legal reason to hire only females in labor and delivery and postpartum. Rationale 2: There is no reason an older male or a female could not be hired as a transporter. Rationale 3: It is not legal to ask questions regarding military service prior to hire. Rationale 4: Being bilingual is a qualification necessary for work in some emergency departments. The nurse could not hire based on national origin, just on the basis of speaking more than one language. Rationale 5: There is no reason a man could not be successful as a unit clerk.

Question 4 Type: MCMA The night nurse on the pediatric unit has resigned. The night staff is pleased, because this nurse constantly complained about workload and alienated most staff members. What consequences may result from the loss of this nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Use of agency nurses. 2. Opportunity for overtime. 3. Increase in enthusiasm. 4. A resignation spiral in which more nurses resign 5. Unit performance improves.

Correct Answer: 1,2,3,5 Rationale 1: Unfortunately, agency nurses may need to be used if the position goes unfilled. This is a costly problem. Rationale 2: There may be an opportunity for overtime work for those who desire it. Rationale 3: Without the constant distraction of a complaining nurse the enthusiasm for the job may increase. Rationale 4: Since the nurse who resigned was not liked and was classified as a complainer it is unlikely that this resignation will trigger a resignation spiral. Rationale 5: When a nurse who alienates coworkers and complains frequently leaves, the performance of the unit may improve.

Question 9 Type: MCMA A hospitals budget is incremental. Which statement by the nurse manager reflects use of this type of budget? Standard Text: Select all that apply. 1. The finance department sent me the budget worksheet with last year's expenses. 2. We have $1,000 left in our education account that we need to spend before the year is over. Who has an idea for a class to attend? 3. I have to justify all our activities as if we have never done them before. 4. I like this type of budget preparation because it is fairly simple and straightforward. 5. In order to create next years budget, I am to start at 80 percent of what we budgeted last year.

Correct Answer: 1,2,4 Rationale 1: Developing an incremental budget may begin with documentation of the previous year's actual expenses. Rationale 2: The disadvantage of an incremental budget is that managers quickly learn to spend all that is in their budget for a specific line item. If budgets are based on the previous year's performance, having budgeted money left over means it is likely that the current year's budget will be cut. Rationale 3: Justification of all activities and expenditures is a characteristic of a zero-based budget. Rationale 4: Incremental or line-item budgeting is fairly simple and straightforward. Rationale 5: Starting with a decreased budget is a form of zero-based budget.

A staff nurse is late for work for the second time this week. When the manager mentions the tardiness, the nurse says, Im so sorry. Ive just got so much going on with my impending wedding. I am so stressed. Which responses by the manager would help this nurse cope? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Good stress can be just as bad as negative stress. 2. We need to get you back in balance. 3. Your personal issues should not interfere with work. 4. Weddings are fun, but they can be stressful as well. 5. If you are late again, I am going to write you up.

Correct Answer: 1,2,4 Rationale 1: Good stress can be just as hard on the body as negative stress. Rationale 2: A balance should exist between stress and the ability to handle it. Rationale 3: The nurse realizes this fact, apologized, and offered an explanation for the tardiness. Rationale 4: Acknowledging the nurses situation may help with coping. Rationale 5: A threatening response will not decrease the nurses stress.

A geriatric client in a long-term-care facility becomes increasingly confused and verbally aggressive as evening approaches. Which actions would the nurse interpret as potentially signaling a violent episode? Standard Text: Select all that apply. 1. The client is moving slowly toward the room door. 2. The client is staring blankly at the nurse. 3. The client suddenly becomes alert and oriented. 4. The client raises his fist. 5. The client says, I know where there is a gun.

Correct Answer: 1,2,4 Rationale 1: The client may be about to flee the room, or may be blocking the nurses exit. Rationale 2: A blank stare could be related to pathology such as dementia or may signal a violent episode. Rationale 3: Alertness and orientation do not signal impending violence. Rationale 4: Preparing for battle signals impending violence. Rationale 5: It is fairly unlikely that a geriatric client in a long-term-care facility has access to a gun. The nurse must be aware of the statement, but should consider the context.

A staff nurse is known for having temper tantrums when the unit is stressful. The nurse slams doors, grumbles, and is demeaning to coworkers. The behavior has never been violent, but today it is becoming more threatening. The nurse just came into the station and said, my nurse assistant is stupid. I'm not going to put up with that much longer. She needs to be put in her place. How should the manager respond to this situation? Standard Text: Select all that apply. 1. The nurse should be removed from the unit. 2. A critical incident report should be written about the behavior. 3. The manager should explain that this is a good nurse who has difficulty tolerating stress. 4. Security should be notified of the behaviors. 5. The manager should warn other staff to stay clear of this nurse for the rest of the shift.

Correct Answer: 1,2,4 Rationale 1: The nurse should be removed from the situation. Rationale 2: This behavior should be documented. Rationale 3: Making excuses for this nurse is not appropriate. The nurses temper is escalating and may grow out of control. Excuses violate the zero-tolerance policy. Rationale 4: As the behaviors are escalating, security should be notified. Rationale 5: The nurse should not be allowed to remain on the unit for the rest of the shift.

A highly intoxicated client is brought to the emergency department. Paramedics report that the client was violent during transport and tried to kick the door out of the ambulance. How should the nurse prepare before seeing this client? Standard Text: Select all that apply. 1. Remove any hemostats from the pocket. 2. Take off the stethoscope and place it in the pocket. 3. Ask the paramedics to place the client in leather restraints. 4. Enter the room calmly, with a smile. 5. Give the client 20 minutes or so to calm down before the assessment begins.

Correct Answer: 1,2,4 Rationale 1: The nurse should remove any potential weapons. Rationale 2: A stethoscope hung around the neck is a convenient handle for anyone who would like to gain control of the nurse. Rationale 3: The nurse should not ask the paramedics to perform this intervention. Rationale 4: Being calm and pleasant can help defuse potentially violent situations. Rationale 5: The nurse should not wait 20 minutes to see a client who is highly intoxicated.

During orientation a newly employed nurse asks about the process of reporting such things as bomb threats to the organization. The person conducting the orientation says, Well, I guess you should call 911. What is incorrect about this statement? Standard Text: Select all that apply. 1. The person who is doing the orientation should be aware of the reporting policy. 2. The nurse should have been told to notify security. 3. The nurse should never call 911 from the hospital. 4. The nurse should have been told to follow the reporting policy. 5. The nurse should have been reported as suspicious for asking the question.

Correct Answer: 1,2,4 Rationale 1: The person conducting the orientation should be aware of the policy and relay the information accurately and with certainty. Rationale 2: Notification of security is essential. Rationale 3: There could be instances in which a nurse should call 911 from the hospital. In a small hospital with no full-time security, calling 911 may be the immediate response. Rationale 4: The hospital must have a bomb threat reporting policy. This would be a good time to introduce it to the orientation group. Rationale 5: There is no reason to report the nurse.

A colleague frequently forwards funny e-mails to everyone on her contact list. The nurse manager does not have time to look at the e-mails and is aggravated when they appear. How should the manager handle this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Set the e-mail filter to divert the messages to a spam folder. 2. Tell the sender that the manager is not allowed to get personal e-mails at work. 3. Forward the e-mails back to the sender. 4. Send the colleague an e-mail that reads, Stop wasting my time with these e-mails. 5. Delete the messages without opening them.

Correct Answer: 1,2,4,5 Rationale 1: If the e-mail can be filtered so that the recipient only has to look at them if desired, they are not as aggravating. Rationale 2: Using a corporate policy to explain reluctance to get these e-mails will save face for the sender and the recipient. Rationale 3: This action takes time and is rude. Rationale 4: Unless the colleague is a dear friend, this e-mail is confrontational and may unnecessarily embarrass the colleague. It may also damage a working relationship. Rationale 5: There is no rule that says that all messages have to be opened. When the message appears, delete it.

The nurse is caring for a client who is aggressive, demanding, and verbally abusive toward staff and visitors. The client says, I'm getting out of here. I'm going to end it all. What immediate action should the nurse take? 1. Attempt to block the exit door. 2. Call security. 3. Attempt to administer a sedative to the client. 4. Notify the clients family.

Correct Answer: 2

Currently clients on a unit are bathed in the morning between 8:00 am and 11:00 am. The nursing staff is contemplating changing that routine to bathing clients in the evening between 7:00 pm and 9:00 pm. Which statement reflects an underlying assumption that might affect the staffs ability to think critically about this change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The day shift just wants to shift work onto the evening shift. 2. Everyone likes to bathe right before bed. 3. I read a research article that reported that clients sleep better if they have been bathed right before bedtime. 4. The physician staff will be upset if we change our morning routine. 5. If we let them change this, they will want to make lots of other changes, too.

Correct Answer: 1,2,4,5 Rationale 1: This is an underlying assumption about why this change is being considered. Rationale 2: This speaker assumes that everyone likes to bathe right before bed, not taking into consideration that some like to bathe in the morning. Rationale 3: A research article report is not an assumption, but is based on evidence. Rationale 4: This is an assumption that might well be erroneous. Rationale 5: This is an assumption.

Question 9 Type: MCMA A hospital on the Gulf Coast of the United States would list which situations among its top vulnerabilities? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Flooding 2. Hurricane 3. Earthquake 4. Tornado 5. Industrial accident

Correct Answer: 1,2,4,5 Rationale 1: Flooding would be a big concern for a hospital on the gulf coast. Rationale 2: Hurricane would be a big concern for a hospital on the gulf coast. Rationale 3: Earthquakes may occur on any fault line, but this is not a primary concern on the gulf coast. Rationale 4: Tornadoes often accompany hurricanes and would be a big concern on the gulf coast. Rationale 5: Industrial accidents would be of concern related to the large oil production capacity of the gulf waters.

Question 19 Type: MCMA A nurse who is obtaining a bachelors degree in nursing is formulating a project regarding nurses job satisfaction. The nurse is aware that research has shown job satisfaction is related to which factors in the working environment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Appropriate staffing 2. Involvement in organizational decision making 3. Ability to work overtime 4. Being recognized for a job well done 5. Good relationships among staff

Correct Answer: 1,2,4,5 Rationale 1: Nurse retention may be a result of enhancing the work environment. Appropriate staffing is a positive indicator of a healthy work environment. Rationale 2: Involvement in organizational decision making improves the overall work environment for nurses. Rationale 3: Being able to work overtime is not universally important. Rationale 4: Recognition for doing ones job well is an important component of job satisfaction. Rationale 5: Good staff relationships improve the work environment.

An experienced ICU nurse manager is orienting a newly hired nurse manager to the organization. The ICU manager makes occasional notes in a small notebook. The new manager asks why the ICU manager is taking notes. What are the most likely rationales for this behavior? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. It saves me time in the long run, 2. Taking notes helps me to address issues immediately so they do not escalate. 3. Although this looks time consuming, it is just how I learned to manage. 4. It helps me to remember what to address in staff meetings. 5. Having notes helps protect me when evaluations are written.

Correct Answer: 1,2,4,5 Rationale 1: Taking notes does save time for the manager when evaluations are written or if other issues come up on the unit. Rationale 2: On a busy unit, the manager must rely on written notes as a reminder of issues that should be discussed with staff. Rationale 3: Note taking is quick and this statement does not provide rationale for why notes are taken. Rationale 4: Notes will help the manager remember what should be addressed in staff meetings. Rationale 5: Having notes about the incidents cited in evaluations helps to protect the manager in case a staff member disputes the situation.

A nurse manager has been terminated for failing to follow institutional policy and procedures. Upon reviewing the managers files, the supervisor discovers multiple unfinished employee evaluations from the last two years. The supervisor is faced with which concerns? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Finding someone with enough knowledge of the employees work to complete the evaluation processes 2. How to share evaluation information with employees 3. The legal steps necessary to invalidate the in-process evaluations and begin new evaluations 4. Whether the care provided on the unit has been safe and effective 5. How long it has been since employees have had a valid evaluation

Correct Answer: 1,2,4,5 Rationale 1: The evaluator must have direct knowledge of the employees work. The supervisor must find people who have that knowledge who are qualified to evaluate the work, whether the current evaluations are finished or new ones are started. Rationale 2: Evaluations must be shared with the employee. If these evaluations were not finished, it is likely they were not shared. Rationale 3: No legal steps are necessary to invalidate these in-process evaluations. Rationale 4: Without a valid evaluation process, the care on the unit has not been assessed. Rationale 5: Employees should be evaluated at least once a year.

Question 26 Type: MCMA A hospital has written a well-defined surge call-back system for employees to use in case of a disaster. What are key vulnerabilities of this system? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Employees may be unwilling to come back into the disaster. 2. Employees may be personally affected by the disaster. 3. Many employees will request additional pay for shifts worked during disasters. 4. There may be no way to contact employees for call-back. 5. The employee may not physically be able to return to the hospital.

Correct Answer: 1,2,4,5 Rationale 1: There is no assurance that employees will respond by returning to work once a disaster has happened. Rationale 2: It is impossible to know if employees will be personally affected by the disaster. For example, if the employees home is destroyed by a wildfire, that employee would have pressing family needs. Rationale 3: This may occur, but is not a key impediment. Rationale 4: If utilities such a telephone and cell phone towers are destroyed, there may be no way to contact the employee to come back to the hospital. Rationale 5: There may be physical impediments such as washed out roads, snow-packed roads, or debris-covered roads that prevent employees from returning to the hospital.

A nurse manager is committed to establishing an environment that supports critical thinking and creativity. What strategies would help in this effort? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Provide opportunities for staff to interact with nurses from outside the facility. 2. Give the nurses freedom to design their work environment. 3. Create a spreadsheet for nurses to complete describing their creative efforts. 4. Assign each nurse 15 minutes of a staff meeting to talk about his or her creative efforts. 5. Be receptive to ideas even if they seem strange at the beginning.

Correct Answer: 1,2,5 Rationale 1: Exposure to new ideas and a fresh environment outside the facility increases creativity. Rationale 2: Freedom is necessary to support the creative process. Rationale 3: Filling in a spreadsheet is a bureaucratic, regimented strategy that will not foster creativity. Rationale 4: Making creativity an assignment is a sure way to stifle it. Rationale 5: Being receptive to new ideas encourages creativity.

Question 4 Type: MCMA A nurse has an interview with the nurse recruiter at a large metropolitan hospital. During the nurses education, clinical practice was conducted in smaller facilities. Which topics would be good for the applicant to focus on during the interview? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Information regarding the position and the organization 2. The nurses past experiences 3. Salary 4. Benefits 5. The nurses strengths and weaknesses

Correct Answer: 1,2,5 Rationale 1: During the interview, the nurse should obtain information about the position and organization. Rationale 2: During the interview, the nurse should describe experiences and education. Rationale 3: Once the job has been offered or the interviewer inquires about the applicants interest in the job, then it is appropriate to discuss salary. Rationale 4: Once the job has been offered or the interviewer inquires about the applicants interest in the job, then it is appropriate to discuss benefits. Rationale 5: During the interview, the nurse should identify personal strengths and weaknesses.

A newly hired registered nurse is having difficulty focusing and performing nursing tasks. The nurse manager has noted a decrease in the nurses performance. When meeting with the nurse, the manager learns the nurse has recently gotten married and moved into a new home. The client load in the unit has returned to normal levels from very high levels and another newly hired nurse was terminated for disruptive behavior. The nurse reports that everyone has been so nice and they try to help me. Which situations are most likely causing this nurses stress? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Marriage 2. Purchasing a new home 3. Decreased workload 4. Assistance from other nursing staff 5. The coworker who was terminated

Correct Answer: 1,2,5 Rationale 1: Even though getting married is a happy time, the wedding can be very stressful to plan. Adapting to married life can also be stressful. Rationale 2: Purchasing a new home is very stressful. Rationale 3: Typically, a reduced workload is not stressful. Rationale 4: Assistance from other nursing staff should not be stress inducing. Rationale 5: Working alongside a noncompliant coworker who is terminated can be very stressful.

The nurse manager has asked that another staff nurse position be funded for the unit. The supervisor denies the request. Which statements by the manager are examples of negative assertion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I know I havent been too careful in keeping personnel costs low, but we are really going to need another position. 2. I dont see why another position cannot be funded. We have met our budget each year for the last 3 years. 3. I realize that my staff is not always positive about organizational changes, but having this extra staff member might reduce some of their stress. 4. I can understand what you said about budget being tight, but we still need the position. 5. Do you not understand how hard my nurses are working?

Correct Answer: 1,3 Rationale 1: Negative assertion occurs when the speaker accepts some of the blame for the situation. Rationale 2: This is an example of negative inquiry. Rationale 3: Negative assertion is accepting some of the blame. Rationale 4: This is an example of fogging. Rationale 5: This is a confrontational statement and should be avoided.

A nurse supervisor is aware that nurses in the facility have been under a great deal of stress while working through a major change in the ownership of the hospital. Which nurses would the supervisor be most concerned might develop compassion fatigue? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Emergency department nurses 2. Outpatient diagnostic procedure nurses 3. Nurses working in the trauma surgery unit 4. Nurses working in geriatrics 5. Nurses working in obstetrics

Correct Answer: 1,3 Rationale 1: Compassion fatigue is more likely to occur when the nurse is providing care to people who are traumatized. Emergency department nurses fall in this category. Rationale 2: Outpatient nurses may be somewhat sheltered from caring for trauma patients, which is a major cause of compassion fatigue. Rationale 3: Compassion fatigue is more likely to occur when the nurse is providing care to people who are traumatized. Trauma surgery nurses fall into this category. Rationale 4: Nurses working in geriatrics are not at as great a risk for compassion fatigue as other nurses. Rationale 5: Generally, the risk for compassion fatigue is not as high in nurses working in obstetrics.

Question 29 Type: MCMA A nurse is interested in the possibility of collective bargaining in the workplace. What will the nurse find when researching this possibility? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Most nurses do not work under collective bargaining agreements. 2. As the nurse is a manager, collective bargaining would be of no interest. 3. The National Labor Relations Board (NLRB) has addressed collective bargaining in nursing. 4. The nurse works in a state hospital, where collective bargaining is not possible. 5. The cost of the dues or fees associated with collective bargaining is more than could be gained from joining.

Correct Answer: 1,3 Rationale 1: This is a true statement. Rationale 2: The nurse manager may not be included in the collective bargaining agreement but certainly would have an interest in the process. Rationale 3: The NLRB has addressed many issues that directly impact collective bargaining and nursing. Rationale 4: Whether or not collective bargaining is used depends on the state in which the nurse works. Rationale 5: The fee schedule is set by the union, and the value of unions differs. Global Rationale:

The nurse has just interviewed with a nurse manager. The manager offers the nurse an opportunity to tour the unit and meet potential coworkers. Why is this a beneficial opportunity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. It allows the candidate to learn more about the unit. 2. It allows the candidate to make a final determination about whether the unit is a good work environment. 3. It allows the candidate to make some assessment of coworkers. 4. It allows the candidate to determine nurse-to-client ratios. 5. It allows the candidate a first look at the types of clients served by the unit.

Correct Answer: 1,3 Rationale 1: This tour allows the candidate to see the unit in action and learn more about how it operates. Rationale 2: It is hard to make a logical determination about the unit on one visit, but the nurse will gain information that will be helpful. Rationale 3: The nurse is constantly assessing, and a tour allows contact with coworkers for this assessment. Rationale 4: One tour is unlikely to provide the candidate with this opportunity. Rationale 5: The candidate should be aware of the types of clients served by the unit prior to applying for the position.

Question 27 A nurse manager and a human resources (HR) manager are developing an interview guide for registered nurse positions in critical care units. How should this document be structured? Standard Text: Select all that apply. 1. The questions should be specific to the registered nurse position. 2. Questions should be general enough that they will guide the interview for any critical care unit. 3. Sufficient room should be allowed between the questions so that notes on the interview can be written directly on the guide. 4. Questions should require independent answers and should not be leading. 5. The document should allow space for demographic information such as name, gender, and age.

Correct Answer: 1,3,4 Rationale 1: Questions should be specific to the job responsibilities of a registered nurse. Rationale 2: The questions should be specific to the unit for which the nurse is being hired. For example, a nurse skilled in adult critical care may not be prepared to work in a neonatal intensive care unit. Rationale 3: If notes are taken directly on the guide, it will also serve as a written record of the interview. This written record may be retained or may be destroyed after the position is filled. Rationale 4: Leading questions often have very obvious answers and will not give the interviewers a true impression of the applicant. Rationale 5: Asking about age and making decision based on gender is not legal.

Question 27 Type: MCMA A nurse manager and a human resources (HR) manager are developing an interview guide for registered nurse positions in critical care units. How should this document be structured? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The questions should be specific to the registered nurse position. 2. Questions should be general enough that they will guide the interview for any critical care unit. 3. Sufficient room should be allowed between the questions so that notes on the interview can be written directly on the guide. 4. Questions should require independent answers and should not be leading. 5. The document should allow space for demographic information such as name, gender, and age.

Correct Answer: 1,3,4 Rationale 1: Questions should be specific to the job responsibilities of a registered nurse. Rationale 2: The questions should be specific to the unit for which the nurse is being hired. For example, a nurse skilled in adult critical care may not be prepared to work in a neonatal intensive care unit. Rationale 3: If notes are taken directly on the guide, it will also serve as a written record of the interview. This written record may be retained or may be destroyed after the position is filled. Rationale 4: Leading questions often have very obvious answers and will not give the interviewers a true impression of the applicant. Rationale 5: Asking about age and making decision based on gender is not legal. Global Rationale: Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 15-4: Distinguish between appropriate and inappropriate questions to ask during an interview.

Question 12 Type: MCMA A nurse who works in a hospital with a collective bargaining unit requires disciplining. Which actions by the nurse manager are critical? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Coaching the nurse as appropriate 2. Letting the collective bargaining unit handle any disciplinary needs 3. Reviewing policy and procedures with the nurse 4. Discussing expectations that were not met 5. Directing any questions the nurse has to the union representative

Correct Answer: 1,3,4 Rationale 1: The manager is responsible for many of the same activities as in any situation. Coaching is included in these responsibilities. Rationale 2: The manager is responsible for discipline in the unit just as in any other situation. Rationale 3: A review of policy and procedures is part of all disciplinary issues. Rationale 4: Discussing unmet expectations is a part of all disciplinary issues. Rationale 5: The manager should answer questions that pertain to the actions for which the nurse is being disciplined.

Question 30 Type: MCMA A nurse manager strongly believes that nurses should seek advanced educational degrees. The manager encourages this attitude in staff nurses. What are the dangers of this practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Nurses who achieve an advanced degree are more mobile. 2. Staff nurses may have a higher degree than the manager. 3. Staff members may need time off to attend school. 4. Staff members may resign to attend school full time. 5. Salaries are higher for nurses with advanced degrees.

Correct Answer: 1,3,4 Rationale 1: The nurse with an advanced degree has greater job opportunity and is more mobile. Rationale 2: This may be the case, but should not be a problem. Rationale 3: Scheduling around several nurses who have school schedules can be difficult. Rationale 4: There is a chance that nurses may resign in order to attend school on a full-time basis. Rationale 5: While salaries are higher for nurses with advanced degrees, the manager should know well in advance that a staff member is in school and should have opportunity to budget for those salaries.

In an activity log, a nurse records attendance at an education seminar as, Class on arrhythmia recognition, State College, taught by Sue Smith, RN. What else would be valuable for the nurse to include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The exact title of the seminar or event 2. Which colleagues attended with the nurse 3. Who paid for the course and what it cost 4. The date 5. Any certifications achieved

Correct Answer: 1,3,4,5

Which statement describes the primary difference between group and individual decision making, besides the number of individuals involved? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A decision made by a group is often better than a decision made by one person. 2. A decision made by an individual results in greater commitment. 3. Groups can provide more input into the process. 4. A decision made by a group can create a greater obligation to achieve results. 5. Routine decisions are more often made by individuals.

Correct Answer: 1,3,4,5 Rationale 1: Decisions made by groups are often better than those made by individuals because there is more input into the process. Rationale 2: There is no evidence to support that a decision made by an individual results in greater commitment. Rationale 3: Decisions made by groups are often better than those made by individuals because there is more input into the process. Rationale 4: The peer pressure of a group can create a greater commitment or feeling of obligation to achieve results. Rationale 5: Routine decisions are often made by individuals, with no group input necessary.

Question 26 Pharmacy reports that the medication records of a unit have begun to show frequent corrections. What other signs of diversion would the manager look for on the unit? Standard Text: Select all that apply. 1. Chart review on effectiveness of pain control 2. Increase in clients with conditions requiring pain medications 3. Increase in use of doses of as-needed narcotics that results in wastage 4. Chart review that reveals that clients require much more narcotic pain medication on one shift than on others 5. Narcotic containers that look as if they have been altered

Correct Answer: 1,3,4,5 Rationale 1: If many clients report their pain is not controlled, diversion may be occurring. Rationale 2: An increase in clients requiring pain medications is likely census related. Rationale 3: If the nurse has a choice of doses and is trying to divert medications, a smaller dose might be given resulting in a larger wastage that is then diverted. Rationale 4: If one shift is giving much more pain medication that the other, it may be because someone is diverting drugs on that shift. It may also mean that inadequate pain control is being given on the other shift because someone is diverting drugs. Rationale 5: Altering the container is a method of diversion.

Question 19 A nurse manager is struggling with two marginal nurses and goes to the supervisor for advice. How should the supervisor advise the manager? Standard Text: Select all that apply. 1. Continue to be persistent in your work with these nurses. 2. You can fire them at any time. 3. Be fair and consistent with them. 4. You must continuously assess the rest of your staff as you work with these two nurses. 5. You must continue to address the issues with these nurses as they arise.

Correct Answer: 1,3,4,5 Rationale 1: Persistence is a key to being perceived as fair and just. Rationale 2: Termination practices are governed by strict procedures that must be followed to protect both the manager and the institution. Rationale 3: Fairness and consistency are keys to being perceived as just. Rationale 4: The manager must be aware of the impact of marginal nurses on the remainder of the staff. Rationale 5: The manager cannot ignore any issues that arise with these nurses.

Question 17 Type: MCMA The chief nurse officer (CNO) is planning the budget for the coming year. A new position has been added to the nursing administration cost center. The CNO is determining how many benefit hours should be allocated for this new position. Which days should the CNO include in this calculation? Standard Text: Select all that apply. 1. Sick days 2. Weekend days 3. Vacation days 4. Holidays 5. Bereavement days

Correct Answer: 1,3,4,5 Rationale 1: Sick days are benefit days. Rationale 2: Weekend days are not benefit days. Rationale 3: Vacation days are benefit days. Rationale 4: Holidays are benefit days. Rationale 5: Bereavement days are benefit days.

An organization has changed its performance appraisal process and is conducting training for managers. What topics should the trainer include in the agenda for this session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. What a reasonable job performance should look like 2. How to conduct a disciplinary meeting 3. How to complete the evaluation form 4. How to give the employee feedback on evaluation 5. Use of anecdotal notes

Correct Answer: 1,3,4,5 Rationale 1: The manager must be able to differentiate reasonable job performance from unreasonable job performance. Rationale 2: Discipline is not a part of the evaluation process. Rationale 3: The evaluation form becomes a part of the employees permanent file and is legally discoverable. It must be completed accurately and completely. Rationale 4: Feedback is important and must be offered and documented. Rationale 5: Anecdotal notes or critical incident notes are a vital part of the evaluation process.

A nurse with an associate degree in nursing is interested in obtaining more education but is unsure if it is wiser to obtain a baccalaureate degree in nursing or to pursue certification. The answers to which questions would assist the nurse in making a decision? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Am I interested in nursing management? 2. Which goal can be accomplished at the least expense? 3. Do I want to go to graduate school? 4. What are my future options in my current position? 5. Is either option available online?

Correct Answer: 1,3,4,5 Rationale 1: The nurse should determine interests prior to deciding which degree to pursue. Rationale 2: The expense it will take to achieve the goal should not be the primary factor determining which one to choose. Rationale 3: The nurse should think about future educational goals when deciding upon a degree. Rationale 4: The nurse should identify current advancement possibilities when considering further education. Rationale 5: Online education is available for many degrees and certifications. This information may make the decision clearer.

Question 29 Type: MCMA The nurse manager is updating the position control sheet for the fiscal year prior to beginning a new budgetary cycle. What would the manager include in this sheet? Standard Text: Select all that apply. 1. The FTE factor for an LPN hired this month 2. The current wage range for RNs working on the units 3. The names of all unit clerks working in the unit 4. The level of licensure of a nurse working on the unit 5. The fact that two RNs have retired this year

Correct Answer: 1,3,4,5 Rationale 1: The position control sheet includes the names and FTE factors for each individual employed by the unit. Rationale 2: Wage ranges are not included in this information. Rationale 3: The names of all unit employees are part of the position control sheet. Rationale 4: The position control sheet categorizes those working on the unit by position. Therefore, the licensure level of the nurse would be indicated. Rationale 5: Resignations are recorded on this sheet.

Which statements indicate that a nurse manager is using time reactively? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. We were so busy yesterday that I did not get the schedule completed. 2. I knew that we would be busy over the holiday, so I ordered extra supplies. 3. We have so many new graduates on our unit that our work is never caught up. 4. I am putting a summary of a research article on the board each week since I realize many of the nurses do not read journals. 5. I am really concerned about what the nursing supervisor said about our unit. I cant get it off my mind.

Correct Answer: 1,3,5 Rationale 1: Being too busy to get work done is reactive, not proactive. Rationale 2: The manager knew the unit would be busy and could control lack of supplies by ordering more. This is a proactive statement. Rationale 3: The manager should predict that new graduates require more time to complete tasks and should plan for that problem. Rationale 4: The nurse manager knows that nurses need to keep current and also knows that many of the nurses supervised do not read journals. A proactive solution to this problem has been proposed. Rationale 5: A proactive approach would be to ask the supervisor for clarification about the remark.

Which statements exemplify the attributes of critical thinking essential to nurses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I am always curious about why we do things the way we do. 2. I think we need to hurry up and make a decision. 3. Can you help me understand your perspective a little better? 4. I dont think that your concern is necessarily pertinent to this issue. 5. I dont think I can make that decision until I have more information.

Correct Answer: 1,3,5 Rationale 1: Curiosity and a willingness to examine underlying assumptions are characteristic of a critical thinker. Rationale 2: A critical thinker is not in a hurry to make a decision but waits until all the facts are known and can be considered. Rationale 3: The critical thinker considers the possible alternative perspectives. Rationale 4: The critical thinker does not discount the concerns of others who have knowledge of the issue. Rationale 5: The critical thinker collects and analyzes the facts before considering any decision.

A nurse is participating in time-management education. This weeks assignment is to compile a list of personal goals. Which of these goals should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I will lose 10 pounds by Christmas. 2. My family will have more fun. 3. I will read for pleasure for 1 hour every day after work. 4. I will not be late for work. 5. We will save $200 monthly for the next 12 months for a car down payment.

Correct Answer: 1,3,5 Rationale 1: This is a measurable, time-defined goal. Rationale 2: This is not a measurable goal and has no time component. Rationale 3: Pleasure reading is a personal goal. This statement is measurable and has a time frame. Rationale 4: Not being late for work is a job-related goal. Rationale 5: Saving for a car down payment is a personal goal. This statement is measurable and has a time component.

Question 5 A group of nursing students have just arrived on the unit. Which actions by staff would be considered uncivil to these students? Standard Text: Select all that apply. 1. The unit clerk groans when the instructor enters the nursing station with the students. 2. A nurse quietly says, please do not assign a student to me today. I have two very sick clients who are going to require my full attention. 3. A nurse whispers, Not students again today. 4. A nursing assistant asks the students how long they have been in school. 5. A transport worker says, just great, more students to get in the way today.

Correct Answer: 1,3,5 Rationale 1: Any action that indicates the students are unwelcome is not civil. Rationale 2: This nurse has not been uncivil, but is stating a fact about the acuity of clients. Rationale 3: This whisper is not civil, despite the level at which it is spoken. Rationale 4: This is a valid statement and is civil. Rationale 5: The intent of this remark is probably not civil.

Question 10 Type: MCMA The human resources (HR) department is considering motivating employees to maintain good attendance by changing some organizational practices. Which items should HR consider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Offering a discount on the cost of on-site child care for employees with good attendance records 2. Encouraging managers to involve employees in the decision making on the unit 3. Banning an employee with more than two absences in a pay period from working overtime in the next pay period 4. Working with managers to change the culture of the units on which absences are frequent 5. Entering the names of employees who have no absences in a 3-month period in a drawing for a paid day off

Correct Answer: 1,3,5 Rationale 1: On-site child care is a motivating factor in itself. Adding a discount to those with good attendance is an additional motivating factor. Rationale 2: Shared decision making is a change to the job itself. Rationale 3: This policy would serve as punishment for those seeking overtime wages and is a change in organizational practice. Rationale 4: This is an example of changing the absence culture. Rationale 5: A reward for having no absences is a change in organizational practice.

An organization has adopted the peer review process of evaluation. The manager shares which information with staff? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Begin to work on a portfolio that shows how you have met your work goals for this year. 2. All of you will be called on to review each of the other nurses working on the unit. 3. If you are a member of a peer review committee, you will submit a written evaluation to me. 4. The evaluation will be based solely on the input of the peer committee. 5. This change has occurred as a result of our move to self-governance.

Correct Answer: 1,3,5 Rationale 1: The portfolio is a part of the peer review system of evaluation. Rationale 2: Generally, the peer review process involves two to four nurses reviewing the work of a peer. All nurses may be involved at some point, but not all nurses will review the work of every nurse. Rationale 3: The members of the peer review committee submit a written evaluation to the manager. Rationale 4: The manager also completes an evaluation. Rationale 5: Peer review is often used in self-governance models.

When a nurse enters the room, the client states, He has a gun, and points toward a male visitor. The nurse does not see a gun. What should the nurse do? 1. Question the visitor regarding the statement. 2. Contact security. 3. Call for another nurse to assist in confronting the visitor. 4. Notify the clients physician.

Correct Answer: 2

A nurse managers supervisor reports that many staff members have complained about the managers rigidity. What situations reflect this rigidity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The manager has historically used trial and error as a decision-making strategy. 2. The manager takes unnecessary risks when staffing the unit. 3. The manager is not concerned when staff members arrive late to work. 4. The manager uses old ways of thinking to solve the day-to-day issues of the unit. 5. The manager does not consider the advice of the unit comanager when making a decision.

Correct Answer: 1,4 Rationale 1: A history of ineffective trial and error solutions to problems tends to make the manager rigid. Rationale 2: Generally, fear of risk taking is characteristic of a rigid management style. Rationale 3: Rigidity in personality often translates to rigidity in management style. A rigid manager would be upset if staff members routinely came to work late. Rationale 4: Using old ways of thinking to solve new problems is characteristic of rigid management. Rationale 5: Rigid managers typically prefer to make decisions independently.

Question 16 Type: MCMA A nurse manager of a medical unit and a nurse manager of a critical care unit are discussing their personnel budgets. The medical unit budget is higher than the critical care unit budget. What are plausible reasons for this difference? Standard Text: Select all that apply. 1. There is a higher turnover rate of nursing staff on the medical unit. 2. Costs were incurred during a recent remodeling of the medical unit. 3. The client acuity on the critical care unit is higher. 4. The critical care manager is a better manager than the medical unit manager. 5. More staff on the medical unit received premium pay this year.

Correct Answer: 1,4,5 Rationale 1: A higher turnover rate will increase personnel costs because of the need for more personnel to train new employees. Rationale 2: The costs of remodeling are not included in the personnel budget. Rationale 3: Increased client acuity generally makes personnel costs rise. Rationale 4: Better management tends to mean a more stable staff, which decreases expenditures. Rationale 5: Premium pay increases personnel costs.

Question 22 Type: MCMA A nurse manager is conversing with a colleague at a national meeting. The colleague states, Ive just never understood why a nurse would want to join a union. What responses by the manager would explain the attraction of unionization? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Its usually a combination of factors such as low wages and high nurse-to-client ratios. 2. Low wages cause so much job dissatisfaction that the nurses unionize. 3. Having to work with supervisors as staff when nurses call in is one reason. 4. Many nurses have supervisors who think they understand what its like to work on the unit every day. 5. Many nurses are frustrated because communication between nurses and administration is so poor.

Correct Answer: 1,4,5 Rationale 1: Unionization becomes an attractive option when a combination of factors causes dissatisfaction. Low wages alone are not usually the cause, but low wages associated with other factors such as high client acuity and ratios may cause nurses to seek unionization. Rationale 2: Unionization is an attractive option when a combination of factors causes dissatisfaction. Low wages alone are not usually the cause. Rationale 3: Supervisors and managers working and assisting as staff would improve nurse/management relations and assist with communication. Rationale 4: Supervisors who assume they know what issues are concerning to the staff do not help create trust in the work environment. Rationale 5: Ineffective communication is often the reason for job dissatisfaction, which can make unionization an attractive option.

Question 23 Type: MCMA Unrest and employee turnover have resulted in a unit being critically understaffed. The human resources department and nurse manager are attempting to recruit new nurses for the unit. How should the history of this unit be presented? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The facts of the history should be presented while maintaining the confidentiality of those involved. 2. The history should briefly be mentioned as some minor problems with staffing. 3. The history should not be mentioned. 4. The recruiters should focus on the positive work environment of the rest of the facility. 5. Steps being taken to correct problems on the unit should be outlined and explained.

Correct Answer: 1,5 Rationale 1: The facts should be presented honestly and as completely as possible without breaching confidentiality. Rationale 2: Unrest and employee turnover cannot honestly be categorized as minor problems with staffing. Rationale 3: It would not be fair to hire a nurse into this unit without providing some history. Rationale 4: Focusing on the rest of the facility is not a fair representation of the work environment a nurse could expect on this unit. Rationale 5: Candidates should be made aware of the problems and what is being done to correct them.

Question 23 Unrest and employee turnover have resulted in a unit being critically understaffed. The human resources department and nurse manager are attempting to recruit new nurses for the unit. How should the history of this unit be presented? Standard Text: Select all that apply. 1. The facts of the history should be presented while maintaining the confidentiality of those involved. 2. The history should briefly be mentioned as some minor problems with staffing. 3. The history should not be mentioned. 4. The recruiters should focus on the positive work environment of the rest of the facility. 5. Steps being taken to correct problems on the unit should be outlined and explained.

Correct Answer: 1,5 Rationale 1: The facts should be presented honestly and as completely as possible without breaching confidentiality. Rationale 2: Unrest and employee turnover cannot honestly be categorized as minor problems with staffing. Rationale 3: It would not be fair to hire a nurse into this unit without providing some history. Rationale 4: Focusing on the rest of the facility is not a fair representation of the work environment a nurse could expect on this unit. Rationale 5: Candidates should be made aware of the problems and what is being done to correct them.

Which step should be taken first when recruiting and selecting nursing staff? 1. Develop a structured interview guide. 2. Become familiar with the position description for the jobs available. 3. Develop a recruitment strategy to attract qualified applicants.

Correct Answer: 2

A night shift supervisor has been called to the emergency department to assist in managing a violent situation with a visitor. Once the violent person has been contained and security and police have responded, what should be the supervisors next action? 1. Notify staff on other nursing units. 2. Notify the violent persons physician. 3. Complete an incident report. 4. No action is necessary; the situation has been managed.

Correct Answer: 3

Question 11 Type: MCMA A nurse manager has reduced absenteeism by increasing each nurses job responsibilities. Why is this strategy effective? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Nurses who feel their job is important realize that others depend upon their presence at work. 2. A nurse who is given additional work responsibilities must work harder to prevent termination. 3. Nurses who have greater responsibilities do not stress over minor responsibilities any longer. 4. A nurse with less responsibility is always less motivated. 5. Having greater responsibilities enriches the job experience.

Correct Answer: 1,5 Rationale 1: When employees feel they are making a real contribution they take greater ownership in their work. Rationale 2: Preventing termination is not the reason this strategy is effective. Rationale 3: Generally, the greater the responsibility, the greater the stress over all aspects of the job. Rationale 4: Many nurses are very motivated even though they may not have as much responsibility as others. Rationale 5: Greater responsibilities often change the flavor of the job so that the nurse enjoys it more.

A night shift nurse is assuming a day shift nurse's assignment, which includes two clients whose pain is being controlled with oral hydrocodone (Lortab). At shift assessment, both clients complain of pain. During shift report, the day shift nurse reports that both clients had just received two hydrocodone (Loratab) tablets for pain. What action should the night shift nurse take? 1. Repeat the medication. 2. Inform the manager of the situation. 3. Call the physician to obtain an order for IV narcotics. 4. Tell the clients that pain medication will be given at the next ordered time.

Correct Answer: 2

A nurse comes to a mandatory education session wearing a shirt with a picture and slogan that is degrading to nursing. What should the manager do first? 1. Tell the employee to go home and change. 2. Check the human resources policies regarding appropriate dress. 3. Ask the employee why the shirt was worn to this event. 4. Bring the employee a scrub shirt from surgery to change into.

Correct Answer: 2

A nurse manager has had issues with a marginal employee. Staff members have complained several times to the manager regarding this employee's competence. Which action by the manager would be appropriate? 1. Discuss the issues at a staff meeting and elicit methods to improve morale. 2. Use progressive discipline to manage the employee. 3. Monitor the staff's performance to determine the lack of civility. 4. Terminate the employee.

Correct Answer: 2

A nurse manager has required that all nursing staff attend an in-service on dealing with verbal threats. A staff nurse wonders why this is necessary since, words don't hurt me. I just ignore them. What is the nurse managers most appropriate response to this statement? 1. Don't argue with me, I said everyone has to be in-serviced. 2. Verbal threats often precede physical violence. 3. I want my staff to be prepared to handle anything. 4. This is a requirement from our accrediting agency.

Correct Answer: 2

A nurse manager is investigating a report made by a staff nurse. The nurse states that a visitor backed the nurse up against a wall and was verbally abusive but did not touch the nurse. How should the manager describe this incident to the human resources (HR) director? 1. As an encounter with a disgruntled family member 2. As violence against the nurse 3. As an incident with a family member 4. As a physical attack against an employee

Correct Answer: 2

A nurse who has a baccalaureate degree in nursing is interested in going to graduate school. The nurse is talking to a peer who is in a nurse practitioner program. Which advice would be beneficial for this nurse in choosing a graduate program? 1. Perform an online search and look for the program that requires the least amount of time to obtain the degree. 2. Meet with faculty and students of various graduate programs. 3. Discuss the graduate schools with a physician. 4. Dont start until you are certain you can finish.

Correct Answer: 2

A nurse who has worked on a unit for 8 years has just accepted a position as a nurse practitioner at an indigent clinic. How should the nurse handle leaving the current position? 1. Leave by the end of the week. 2. Tell the manager as soon as the decision is made. 3. Advise the human resources department prior to the unit manager. 4. Discuss the matter with colleagues well in advance of telling the manager.

Correct Answer: 2

An emergency department (ED) has doubled its client visits within the past year. This has led to increased wait times and overcrowding in the ED waiting room. Which recommendation by the ED nurse manager to the chief nurse officer (CNO) would be most effective? 1. Increase the size of the waiting room and add more beds to the ED unit. 2. Hire more ED nursing staff to manage the increased volume of clients. 3. Hire another ED physician. 4. Hire another registration employee to improve the intake process and reduce the volume in the waiting areas.

Correct Answer: 2

Question 10 Type: MCSA A candidate is concerned that some answers she gave during her interview were vague and lengthy. She relates some of the answers to a peer, saying I dont know what happened. I was just so nervous. What is an appropriate response by the peer? 1. Why did you give those answers? 2. You should have given short and to-the-point answers. 3. You gave good answers. 4. I think your answers were specific.

Correct Answer: 2

Question 21 The human resources (HR) director is planning on attending a career fair and has asked the director of nursing to attend as well. The nursing director replies, I really don't have time to attend. Do you really need a nurse to go with you? Which response by the HR director is most appropriate? 1. Your attendance is necessary to assist me with managing the booth. 2. Your attendance is necessary to answer specific nursing questions. 3. I need your assistances in answering questions about our benefit package and nurse's wages. 4. I would like another person from the organization to assist in representation.

Correct Answer: 2

Question 4 Which question is considered appropriate to ask during an interview? 1. What is the country of your national origin? 2. Do you speak any language in addition to English? 3. Will child care be a problem if you are hired? 4. Are there any holidays on which you would not work?

Correct Answer: 2

Question 9 The nurse manager becomes aware of frequent incorrect narcotics counts on the night shift. This is verified by the pharmacy. What should be the first action taken by the manager? 1. Call a meeting of all night shift employees. 2. Review the staffing pattern and absentee list for the night shift. 3. Ask employees for their perceptions on missing narcotics. 4. Request that security search employee lockers and personal items.

Correct Answer: 2

A nurse manager must place a telephone call to a colleague who always wants to chat socially for several minutes. The manager does not have time for a social call. What is the best time for the manager to make this call? 1. At 9:00 a.m. after physician rounds are complete 2. A few minutes before the colleague usually goes to lunch 3. In the middle of the afternoon 4. First thing in the morning, just after shift report

Correct Answer: 2 Rationale 1: 9:00 a.m. is not the best time to make this call. Rationale 2: A call just before lunch is likely to be limited as the person who receives the call wants to leave the office. Rationale 3: In the middle of the afternoon, people are often looking for distractions from their work. If the nurse does not have time for a social chat, the middle of the afternoon is not a good time to call. Rationale 4: If this call is made first thing in the morning, the colleague is unlikely to have begun a project and may wish to delay starting the workday by chatting. If the colleague does not keep shift hours, he or she may not be at work that early.

A serious disagreement has arisen between two staff nurses. The unit manager elects not to make a decision regarding the disagreement until more evidence is collected. Which part of the nursing process does this managers critical thinking reflect? 1. Assessment 2. Diagnosis 3. Planning 4. Evaluation

Correct Answer: 2 Rationale 1: Assessment is collecting the evidence. Rationale 2: Suspending judgment is equivalent to the diagnosis step. Rationale 3: Planning would occur when information is collected and analyzed and a course of action is being determined. Rationale 4: Deciding which hypothesis is correct is evaluation.

A nurse working in a rehabilitation center notices clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem? 1. Calling local beverage distributors to inquire about service pricing 2. Asking all employees to write down their ideas about a solution 3. Determining what type of drinks most clients might want 4. Encouraging clients to bring a drink from home

Correct Answer: 2 Rationale 1: Calling a local beverage distributor is a classic way to address this problem and does not engage the creativity of the staff. Rationale 2: Asking others to think about different options opens up the possibilities beyond one individuals ideas. This is part of the preparation stage of creativity. Rationale 3: Finding out the drink preferences of the clients is part of the standard information gathering stage of providing drinks and does not reflect creativity. Rationale 4: Simply encouraging clients to bring a drink from home is not a creative approach to solving this problem.

Which statement indicates understanding of how a nurse could improve personal decision-making skills? 1. We should gather a group together to make important unit decisions to ensure fairness. 2. I should practice making decisions by developing potential solutions and then choosing one. 3. We can make a decision and then ask for input from others to make sure it was the right choice. 4. I know I will never be able to improve my decision-making skills because I am not a strong person.

Correct Answer: 2 Rationale 1: Depending on a group is not likely to help the nurse improve personal decision-making skills. Rationale 2: Practicing making decisions will increase the nurses experience, comfort, and overall skill. Rationale 3: Including a we in this process is not as likely to improve the nurses personal decision-making skills as making an individual decision. Asking for input to make certain the choice was correct indicates lack of certainty. Rationale 4: Decision-making skills can be learned regardless of ones perceived personal strength.

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent? 1. Group problem solving 2. Critical thinking 3. Groupthink 4. Satisficing

Correct Answer: 2 Rationale 1: Group problem solving implies that a problem exists, which is not the case in this situation. The task force is comparing two models of practice, not solving a problem. Rationale 2: Critical thinking is a higher-level cognitive process that involves the examination of assumptions, interpretation and analysis of arguments, and the development of a conclusion that can be justified. Rationale 3: Groupthink is a negative phenomenon that occurs in highly cohesive groups that become isolated. There is no evidence that groupthink has occurred in this situation. Rationale 4: Satisficing is a type of decision-making strategy that identifies a strategy that is minimally acceptable. There is no evidence that satisficing has occurred in this situation.

When driving towards a meeting, the nursing supervisor gets a call explaining the meeting is to be delayed for about 30 minutes. Which activity is the best use of this supervisors waiting time? 1. Listen to music on the radio. 2. Drive to the meeting place and read the minutes from the last meeting. 3. Stop by the closest store and get doughnuts to share with everyone. 4. Use the time to make some personal phone calls

Correct Answer: 2 Rationale 1: Listening to music is relaxing but could be wasting time that could otherwise be used to prepare for the meeting. Rationale 2: Using the time to refresh memories from the last meeting is the most productive use of the time. Rationale 3: Getting doughnuts is a nice gesture but is not a productive one. Rationale 4: Using the phone to make personal calls is a waste of professional time.

The nurse manager is counseling a male nurse about several recent incidents in which female nurses complained that he was abrupt and condescending. What advice should the manager give this nurse? 1. Make sure that anything you say is clear and concise. 2. Dont feel as if you are responsible for fixing every problem. 3. Avoid using phrases such as sort of when talking to females. 4. Dont personalize everything.

Correct Answer: 2 Rationale 1: Males tend to communicate clearly and concisely, especially in professional relationships. Rationale 2: There are many gender differences in communication. Male tend to take responsibility and feel the need to fix things. Rationale 3: Using phrases such as sort of is a more common trait of female conversation than of male conversation. Rationale 4: Women tend to personalize, while men are more focused on the issues.

A nurse believes that milk is part of the healthy adults diet. The nurse frequently offers milk to adults as a between-meal beverage. This action is based on which concept? 1. Evidence 2. An underlying assumption 3. An alternative perspective 4. An inquiring attitude

Correct Answer: 2 Rationale 1: Scientific evidence shows that milk is not tolerated by all adults. This action is not based in science. Rationale 2: The nurses assumption is that milk is good for adults. Rationale 3: The nurse has not considered the alternative perspective that milk is not tolerated by some adults. Rationale 4: An inquiring attitude would lead the nurse to investigate research about adult tolerance to milk.

The nurse manager should be most careful not to hold preconceived beliefs when listening to which person? 1. The hospital administrator discussing next years budget 2. A staff nurse the manager has worked with for 25 years 3. A newly licensed nurse who is hesitant to address the manager 4. A physician discussing prognosis with the client and family

Correct Answer: 2 Rationale 1: The manager will probably pay close attention to the hospital administrator because of the position. Rationale 2: When there is a long-term relationship, the listener sometimes thinks they know what the other person is going to say. Careful listening is necessary in these situations. Rationale 3: The manager would be attuned to someone who is new to the organization and who might be hesitant to speak. This is not a common situation in which the manager would have preconceived beliefs. Rationale 4: The nurse manager will likely listen very closely to this conversation without preconceived beliefs.

The nurse has a concern regarding the quality of care being provided in the hospital. What should the nurse consider first before communicating this concern? 1. The medium of the message 2. The relationship between the nurse and the receiver of the message 3. The timing of the message 4. What to include in the message

Correct Answer: 2 Rationale 1: The medium of the message is not the first consideration. Rationale 2: The first consideration is the relationship with the receiver of the message. This will guide the remainder of the choices the nurse will make. Rationale 3: Timing is essential, but it is not the first consideration. Rationale 4: In this situation, the nurse likely has numerous points to express. It might not be the best plan to include them all in the initial conversation.

The nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position? 1. Send an e-mail to the nurse manager, requesting a job interview. 2. Send a written letter and rsum in the mail. 3. Call the nurse manager to ask if any jobs are open. 4. Drop into the nurse managers office to discuss employment options.

Correct Answer: 2 Rationale 1: This approach is too informal. Rationale 2: Applying for a job requires a high level of formality. A written cover letter and rsum are expected by most organizations offering employment opportunities. This submission would be done by e-mail only if that is the organizations specific request. Rationale 3: This approach is too informal. Rationale 4: Dropping in to the managers office is not professional. Any meetings generally occur at the request of the potential employer and would occur after the rsum and cover letter are sent.

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior? 1. This nurse is too inexperienced to realize the behavior is inappropriate. 2. This nurse is learning to be creative. 3. This nurse believes that new nurses are more knowledgeable than those who have worked several years. 4. This nurse misunderstands the work of the committee.

Correct Answer: 2 Rationale 1: This behavior is not inappropriate. Rationale 2: Challenging details is a part of the preparation portion of learning to be creative. Rationale 3: There is no indication that this is the belief of this nurse. Rationale 4: There is no indication that this nurse does not understand the work of the committee.

Question 27 A nurse admits to diverting narcotic drugs while working. The manager says, all nurses who admit diverting narcotics have to be reported to the state board of nursing. How should the nurse interpret this statement? 1. As true, because any nurse who admits diversion must be reported to the states board of nursing 2. As false, because in some states reporting depends on other factors 3. As beneficial, because the state board of nursing will help the nurse find a substance abuse program 4. As career ending, because the state board of nursing is required to suspend the license of any nurse who admits to diverting drugs

Correct Answer: 2 Rationale 1: This is not universally true. Rationale 2: In some states if the nurse completes a substance abuse program, reporting is not done. Rationale 3: This is true in some but not all states. Rationale 4: This is not a true statement.

A newly appointed nurse manager has just completed education on time-management skills. Which statement would the instructor evaluate as indicating this nurse understands the basic concepts of time management? 1. My job as a nurse manager is so dynamic that I probably will not be able to attain true time management. 2. The key to using time management is to respect my time as well as the time of others. 3. If I am going to be able to manage time, the hospital will need to invest in a computer-based time-management system. 4. The most important aspect of time management for me is to manage paperwork flow.

Correct Answer: 2 Rationale 1: Time management is achievable by nurse managers. Rationale 2: The most important aspect is the respect of ones own time, which results in others also respecting that time. Rationale 3: Time management is achievable without sophisticated computer-based time-management systems. Rationale 4: Managing paperwork flow is important, but not the most important aspect of time management.

What is the most important reason that excellent communication skills are essential for nurses? 1. Nurses must communicate with all disciplines. 2. All nursing activities occur in relationships. 3. Interpersonal skills get the work done. 4. Good communication ensures no problems occur.

Correct Answer: 2 Rationale 1: While nurses do communicate with all disciplines, the correct reason is broader. Rationale 2: Nursing activities occurring in relationships make communication skills essential. Rationale 3: Excellent communication skills can get the work done more quickly and effectively, but the correct reason is broader. Rationale 4: Excellent communication skills do not keep problems from occurring.

Question 29 Type: MCSA An employee has called in to report being unable to come to work due to car trouble. This is the third time this has happened in the last 2 weeks. The manager should question which variable in this employees attendance? 1. Ability 2. Motivation 3. Need 4. Supervision

Correct Answer: 2 Rationale 1: Ability to attend is generally linked to such obstacles as car trouble, but since this has happened frequently the manager should look to another issue. Rationale 2: Since this car trouble is frequent, the manager must look to the employees motivation to attend. Why has the employee not arranged better or different transportation? Rationale 3: Need to attend can be linked to motivation, but motivation is a better descriptor in this situation. The employee might need to attend for the salary, but is not motivated to do so. Rationale 4: Supervision has little to do with this scenario.

Question 18 Type: MCSA The medical surgical nursing manager notices the education expenditure for the month is over budget. How should the manager deal with this difference? 1. Complete an expenditure report for the month. 2. Complete a variance report for the months budget. 3. Forward a non-revenue-producing report to the administration. 4. Forward the expense line budget to the administration.

Correct Answer: 2 Rationale 1: An expenditure report for the month would not explain the variance. Rationale 2: A variance report provides a rationale for over expenses for the month that could result from a variety of unexpected expenses. Rationale 3: Non-revenue is not relevant to determining why the unit is over budget. Rationale 4: Expense line budgeting is not relevant to determining why the unit is over budget.

Question 15 Type: MCSA A nursing executive is comparing the entire hospital financials for the month and notes that the medical laboratory's revenue is higher than environmental services. What is a possible explanation? 1. The laboratory has increased charges for its services. 2. Environmental services is a non-revenue-producing cost center. 3. The laboratory is a non-revenue-producing cost center. 4. The nursing units affect the laboratory charges.

Correct Answer: 2 Rationale 1: An increase in charges by the laboratory is not significant in this instance. Rationale 2: Environmental services does not charge clients for its services; it is a non-revenue-producing cost center. Rationale 3: The laboratory does charge clients for its services; it is a revenue-producing cost center. Rationale 4: The nursing unit does affect laboratories revenue, but this is not applicable to the question.

Question 17 An emergency department (ED) manager has an interview scheduled for 8:00 the next morning. The managers usual hours are 8:00 a.m. to 4:00 p.m. This manager has been working as staff due to an increased volume of clients. What action should the manager take to prepare for this interview? 1. Reschedule the interview to a later time. 2. Arrive to work early in the morning to prepare for the interview. 3. Arrive at the usual time and conduct the interview. 4. Have a human resources representative conduct the interview.

Correct Answer: 2 Rationale 1: As the interview is in the morning, there is insufficient time to reschedule. Rationale 2: Arriving to work early will allow the manager to review the resume and focus on the questions to ask the candidate. Arriving at the usual time may result in an inadequate interview. Rationale 3: Arriving at the usual time may result in an inadequate interview. Rationale 4: A human resources representative will not be able to assess the candidate as well as the nurse manager. The interview will likely not be useful and may have to be repeated, which is a waste of everyone's time.

Question 17 Type: MCSA An emergency department (ED) manager has an interview scheduled for 8:00 the next morning. The managers usual hours are 8:00 a.m. to 4:00 p.m. This manager has been working as staff due to an increased volume of clients. What action should the manager take to prepare for this interview? 1. Reschedule the interview to a later time. 2. Arrive to work early in the morning to prepare for the interview. 3. Arrive at the usual time and conduct the interview. 4. Have a human resources representative conduct the interview.

Correct Answer: 2 Rationale 1: As the interview is in the morning, there is insufficient time to reschedule. Rationale 2: Arriving to work early will allow the manager to review the rsum and focus on the questions to ask the candidate. Arriving at the usual time may result in an inadequate interview. Rationale 3: Arriving at the usual time may result in an inadequate interview. Rationale 4: A human resources representative will not be able to assess the candidate as well as the nurse manager. The interview will likely not be useful and may have to be repeated, which is a waste of everyones time.

Question 1 Type: MCSA Which step should be taken first when recruiting and selecting nursing staff? 1. Develop a structured interview guide. 2. Become familiar with the position description for the jobs available. 3. Develop a recruitment strategy to attract qualified applicants. 4. Identify potential applicants who would meet the job description.

Correct Answer: 2 Rationale 1: Before an interview guide can be developed, knowledge of the position is necessary. Rationale 2: Prior to beginning recruitment efforts, those involved in the hiring process must be familiar with the position descriptions for jobs that are available. Rationale 3: Development of a recruitment strategy is effective only after the recruiters understand what is required for the jobs offered. Rationale 4: Identifying potential applicants is part of a recruitment strategy or guides it.

An ICU nurse manager prefers to use a results-oriented system when evaluating employees. Why would the manager prefer this system? 1. It allows for comparison between employees. 2. The employee knows in advance what is expected. 3. It is apparent when an employee stands out against peers. 4. It eliminates the category of excellence from the system.

Correct Answer: 2 Rationale 1: Comparative judgments measure employees against peers. Rationale 2: A results-oriented system evaluates the employee based upon outcomes and the employee knows what is expected. This appraisal system is quantifiable, objective, and easily measured. Rationale 3: Comparative judgments measure employees against peers. Rationale 4: Systems have different scales, but excellence is almost universally included and is not excluded simply because the system is results oriented.

Question 12 Type: MCSA The nurse manager is creating the budget for the next fiscal year. Because the client census has been higher in the past year, more supplies were used. Which type of cost does this reflect? 1. Fixed costs 2. Variable costs 3. Direct costs 4. Zero-based costs

Correct Answer: 2 Rationale 1: Fixed costs are costs that remain the same for the budget period regardless of the activity level of the organization, such as insurance premiums. Rationale 2: Variable costs depend on and change in direct proportion to client volume and acuity, such as client care supply expenses. Rationale 3: Direct costs are expenses that directly affect client care, such as salaries for nurses. Rationale 4: Zero-based costs are not a cost classification.

Question 12 A nurse manager is conducting her first interview. The manager is provided interview guidelines by the human resources (HR) director. Which advice from the HR director is most effective? 1. Follow these guidelines and do not ask personal questions. 2. If you are unsure of a question, ask yourself if the question applies to job performance. 3. You may ask any question as long as its stated in third person. 4. You may ask only the questions that are provided.

Correct Answer: 2 Rationale 1: Following guidelines and not asking personal questions is good advice, but is likely what the manager already knew. Better advice is more specific. Rationale 2: As long as the question is related to job performance, the question is appropriate. Rationale 3: Asking questions in third person may still violate state and federal regulations. Rationale 4: While having an interview guide is helpful, additional questions may be pertinent to this applicant.

Question 12 Type: MCSA A nurse manager is conducting her first interview. The manager is provided interview guidelines by the human resources (HR) director. Which advice from the HR director is most effective? 1. Follow these guidelines and do not ask personal questions. 2. If you are unsure of a question, ask yourself if the question applies to job performance. 3. You may ask any question as long as its stated in third person. 4. You may ask only the questions that are provided.

Correct Answer: 2 Rationale 1: Following guidelines and not asking personal questions is good advice, but is likely what the manager already knew. Better advice is more specific. Rationale 2: As long as the question is related to job performance, the question is appropriate. Rationale 3: Asking questions in third person may still violate state and federal regulations. Rationale 4: While having an interview guide is helpful, additional questions may be pertinent to this applicant.

Question 21 Type: MCSA The human resources (HR) director is planning on attending a career fair and has asked the director of nursing to attend as well. The nursing director replies, I really dont have time to attend. Do you really need a nurse to go with you? Which response by the HR director is most appropriate? 1. Your attendance is necessary to assist me with managing the booth. 2. Your attendance is necessary to answer specific nursing questions. 3. I need your assistances in answering questions about our benefit package and nurses wages. 4. I would like another person from the organization to assist in representation.

Correct Answer: 2 Rationale 1: If the reason for having two people attend the event is just to manage a booth, anyone could attend. The HR director should be specific about why it is important for a nurse to attend. Rationale 2: Specific nursing questions such as nurse-to-client ratios, infection rates, electronic documentation systems, and client safety initiatives are topics with which the HR director has no personal experience. Rationale 3: Answering questions regarding benefits and wages are part of the HR directors role. Rationale 4: If having two people attend is just an effort to represent the organization, any employee could attend. The HR director must be specific about why a nurse should attend.

Which assignment would be in the best interest of a nurse reentering practice following treatment for abuse of mood-altering drugs? 1. Place the nurse on a different unit and allow the administration of all drugs. 2. Reassign the nurse for a period of time to a unit where no mood-altering drugs are given. 3. Retain the nurse on the original unit and allow the administration of mood-altering drugs. 4. Return the nurse to the original unit at a less stressful time, such as night shift.

Correct Answer: 2 Rationale 1: In many cases state law or administrative policy will restrict a recovering nurse in the early post-treatment period from handling controlled substances. Rationale 2: Removal of the temptation is a positive step for the recovering nurse. The best action would be to temporarily have the nurse reassigned to a unit where there are no mood-altering drugs. Rationale 3: If the nurse must be assigned to the original unit, he or she should not administer mood-altering drugs. However, this plan does require informing the other nurses of the situation, which can also be problematic. Rationale 4: Recovering nurses should be discouraged from working evening or night shifts.

Question 7 Type: MCSA A nurse who has been working the evening shift on the hospice unit for 5 years resigns. The nurse says, I just cant work here anymore. These clients are so sad. What is the best strategy for retaining this nurse? 1. Increasing the nurses salary 2. Facilitating a transfer to another nursing unit 3. Offering the nurse a position on the day shift 4. Rewrite the nurses job description

Correct Answer: 2 Rationale 1: Increasing the nurses salary is unlikely to make a difference if the nurse is truly unable to stay due to client conditions. Rationale 2: This nurse is experiencing burnout. The best strategy to retain the nurse for the organization is to transfer the nurse to a new unit with different job responsibilities. This will be a loss to the unit, but a savings for the organization. Rationale 3: The nurse has not indicated that the night shift is the problem. Rationale 4: Changing the job description will not change the fact that the nurse is experiencing burnout from working with dying clients.

Question 29 Type: MCSA A nurse manager is aware that U.S. citizenship is required by a job position being filled. How should the manager handle this requirement during the job interview? 1. Ask the applicant to provide proof of citizenship before the interview is scheduled. 2. Ask the applicant if he or she is an U.S. citizen. 3. Do not ask unless the applicant mentions citizenship. 4. Ask if the applicants family is from the United States.

Correct Answer: 2 Rationale 1: It is not appropriate to ask for proof of citizenship before hiring. Rationale 2: It is appropriate to ask if the applicant is a U.S. citizen. Rationale 3: There is no reason to avoid talking about citizenship. Rationale 4: It is not appropriate to ask questions about the applicants family and their citizenship.

An ICU nurse manager noticed a competent nurse has become forgetful and has made medication errors in the past few months. This type of behavior is unusual for this nurse. What action should the manager take? 1. Issue a written warning to the nurse. 2. Meet individually with the nurse to discuss the behavior. 3. Ask other staff members if they have noticed the behavior. 4. Report the nurse to the human resources department.

Correct Answer: 2 Rationale 1: It is premature to issue a written warning. Rationale 2: Meeting with the nurse will provide information. The nurse may be experiencing unusual stress at home, may be unaware of his or her behavior, or may have a medical condition. The first step should be to address and assess the situation. Rationale 3: It is not appropriate for the manager to involve other staff members. Rationale 4: It is premature to report the nurse to the human resources department.

Question 11 A nurse manager would like to add the statement Provide ongoing education to the client and the clients family to the position description of RNs. Where would this statement be placed in this document? 1. In the job qualifications 2. In the job responsibilities 3. In the job overview 4. In the job benefits

Correct Answer: 2 Rationale 1: Job qualifications are such things as having a current license to practice nursing. Rationale 2: This is a statement of one of the job responsibilities of this nurse. Rationale 3: The job overview is a general statement about the job and does not include specifics like those in the question. Rationale 4: Job benefits include items such as salary, paid holidays, and insurance coverage. The benefits are not included in the position description.

The nursing faculty member requires that last-semester nursing students create a rsum. One student submits a rsum that includes education, past employment, and accomplishments. Which additional information will the faculty member recommend the student include in this rsum? 1. Family information 2. Short-term personal goals 3. Transcript 4. Long-term career goals

Correct Answer: 4

Question 11 Type: MCSA A nurse manager would like to add the statement Provide ongoing education to the client and the clients family to the position description of RNs. Where would this statement be placed in this document? 1. In the job qualifications 2. In the job responsibilities 3. In the job overview 4. In the job benefits

Correct Answer: 2 Rationale 1: Job qualifications are such things as having a current license to practice nursing. Rationale 2: This is a statement of one of the job responsibilities of this nurse. Rationale 3: The job overview is a general statement about the job and does not include specifics like those in the question. Rationale 4: Job benefits include items such as salary, paid holidays, and insurance coverage. The benefits are not included in the position description.

Question 30 Type: MCSA A nursing assistant tells a nurse, I am going to have to call in sick tomorrow because I don't have a babysitter. How should the nurse respond to this information? 1. The assistant's sick time is earned and should be used in any way the assistant wishes. 2. The assistant should use personal time, not sick time for this situation. 3. The assistant's absence will not be a major problem for the unit as long as only one day is missed. 4. It will be okay for the assistant to miss a day because it will help another assistant get overtime wages.

Correct Answer: 2 Rationale 1: Misuse of sick time has a negative impact on the unit's finances and perhaps on the quality of care provided. Rationale 2: Most facilities award personal days that should be used for situations such as this. Rationale 3: The nurse does not know how much impact the assistant's absence will have on the unit. Rationale 4: It may be helpful for the assistant to get overtime wages, but it is not for the good of the unit.

Question 20 Type: MCSA The nursing staff at a hospital is upset regarding nurseclient ratios. One of the nurses says, Our contract is not being honored. I think we need to tear it up and strike, starting tomorrow. Which response by the union representative is most appropriate? 1. We cant strike until we have given administration 10 days notice of our desire to change the contract. 2. The FMCS (Federal Mediation and Conciliation Service) has to have 30 days notice of our intent to strike. 3. I have to let the medical chief of staff know we are going to strike at least 30 days before it happens. 4. I have to meet with the Board of Directors and tell them 24 hours in advance.

Correct Answer: 2 Rationale 1: Notice to change the contract must be given 90 days in advance. Rationale 2: The FMCS is notified if agreement has not occurred within 30 days of the notification to terminate the contract. Rationale 3: The notification of intent to strike goes to the management, not the chief of staff. The notice is 10 days. Rationale 4: Notice of intent to strike is given farther in advance than 24 hours and must be in writing.

Question 7 Type: MCSA During an interview with a potential employee, the nurse manager tells the individual that an additional 10 percent of the hourly rate will be paid for working the 7:00 pm7:00 am shift. What is another way the manager could have described this difference in pay? 1. You will receive an additional 10 percent for overtime. 2. The night shift differential is 10 percent. 3. Your evening premium is 10 percent. 4. You will get a 10 percent cost-of-living raise for working the night shift.

Correct Answer: 2 Rationale 1: Overtime is paid to personnel who work more than 40 hours per week. Historically, overtime is calculated by multiplying the amount of overtime worked by 1.5 times the hourly rate. Rationale 2: Most facilities use a set percentage to be paid to personnel who work evenings, nights, weekends, and holidays, which is known as a shift differential. Rationale 3: Premiums are fixed dollar amounts added to the base rate of an employee who has earned a certification or has some advanced clinical achievement. Rationale 4: Cost-of-living raises are factored into budget projections and are not related to shift work.

Question 4 Type: MCSA Which question is considered appropriate to ask during an interview? 1. What is the country of your national origin? 2. Do you speak any language in addition to English? 3. Will child care be a problem if you are hired? 4. Are there any holidays on which you would not work?

Correct Answer: 2 Rationale 1: Questions about an applicants place of birth are inappropriate during an interview. Rationale 2: The recruiter may inquire about language skills such as reading and writing of a foreign language. Rationale 3: Questions about the number and ages of the applicants children or child care are inappropriate. Rationale 4: Asking about holidays the applicant would not work is inappropriate.

Question 3 What should a nurse manager consider when including a staff nurse in an interview of an applicant? 1. Restricting the number of questions the nurse can ask 2. Providing the nurse with an orientation program on interviewing techniques 3. Allowing the nurse to provide information but not the ability to ask the applicant questions 4. Allowing the nurse to ask and answer all questions freely

Correct Answer: 2 Rationale 1: Restricting the nurse's ability to ask and answer questions of the applicant defeats the purpose of having a staff member present during the interview. Rationale 2: An orientation program provides the nurse with the state and federal guidelines to ensure appropriate questions are asked. Rationale 3: Restricting the nurse's ability to ask and answer questions of the applicant defeats the purpose of having a staff member present during the interview. Rationale 4: Allowing the nurse to ask questions freely could violate state and federal regulations governing the interview.

Question 3 Type: MCSA What should a nurse manager consider when including a staff nurse in an interview of an applicant? 1. Restricting the number of questions the nurse can ask 2. Providing the nurse with an orientation program on interviewing techniques 3. Allowing the nurse to provide information but not the ability to ask the applicant questions 4. Allowing the nurse to ask and answer all questions freely

Correct Answer: 2 Rationale 1: Restricting the nurses ability to ask and answer questions of the applicant defeats the purpose of having a staff member present during the interview. Rationale 2: An orientation program provides the nurse with the state and federal guidelines to ensure appropriate questions are asked. Rationale 3: Restricting the nurses ability to ask and answer questions of the applicant defeats the purpose of having a staff member present during the interview. Rationale 4: Allowing the nurse to ask questions freely could violate state and federal regulations governing the interview.

A nurse has always been interested in the legal nurse field. What would be the best program in which to learn about this field? 1. A seminar in which the nurse can obtain certification as a legal nurse as quickly as possible 2. A seminar that offers a variety of speakers addressing the legal nurse profession 3. An accredited program by a legal nurse association 4. A program in which lawyers speak of the opportunities available for legal nurses

Correct Answer: 3

Question 8 Type: MCSA The hospital is hiring several new nurses for an expanded OB unit. The manager explains to the current staff that due to a shortage of nurses, salary compression is occurring. How should the current nurses interpret this statement? 1. There will be no raises in the near future. 2. The new nurses starting salaries will be close to what the current nurses are making. 3. All nurses will receive a merit raise for training new staff. 4. Review of salary structure done while hiring these nurses will result in raises for all current nurses.

Correct Answer: 2 Rationale 1: Salary compression is not linked to raises. Rationale 2: Salary compression is the effect of higher starting pay of new nurses resulting in lower salaries for long-term employees. This results in the wages of new nurses being just below or even higher than that of current nurses. This is a quick fix to a nursing shortage, but a dangerous strategy, and it may result in dissatisfaction and turnover of more experienced nurses. Rationale 3: Salary compression is not linked to merit raises for training staff. Rationale 4: Salary compression is not linked to raises for current employees.

Question 24 Type: MCSA A hospital has used capital funds to purchase a new piece of diagnostic equipment. The hospital's chief financial officer (CFO) says, the cost of this equipment will be expensed out across all units that use it. How should the nurse manager interpret this statement? 1. The equipment is jointly owned by all units that use it. 2. If clients on the managers unit require the use of this equipment, a portion of the cost will be charged to the unit. 3. The equipment will be rented to the units for use. 4. The nurse manager will ask physicians to refrain from using the equipment.

Correct Answer: 2 Rationale 1: The equipment is owned by the hospital. Rationale 2: The cost of the equipment will be spread out among the budgets of all the units whose clients require its use. Rationale 3: The equipment is not rented to the units for use, but the unit must share in the cost to use the equipment. Rationale 4: It is not appropriate for the nurse to attempt to influence care based upon having to pay for equipment.

Question 13 Type: MCSA An ICU nurse manager states, The hospital has a union but I wouldnt advise joining, to a newly hired nurse. The human resources (HR) director is informed of this comment. How should the HR director respond? 1. Call the new nurse and explain that joining the union is encouraged by the hospital. 2. Remind the manager that there is to be no interference with an employees decision to join the union. 3. File a grievance against the manager. 4. Terminate the manager.

Correct Answer: 2 Rationale 1: The hospital should neither encourage nor discourage employees from joining the union. Rationale 2: The managers role is not to interfere with the employees right to organize. The manager should not dominate; encourage or discourage union membership; terminate an employee for filing a charge with the NLRB; or refuse to bargain collectively. The HR director should clarify this role with the manager. Rationale 3: There is no reason to file a grievance. Rationale 4: Unless this manager makes it a practice to tell employees to avoid the union and has continued to do so after being apprised of the regulations, there is no reason for termination.

Question 11 Type: MCSA A nurse manager enters the staff break room. The manager overhears the nursing staff discussing wages and paid time off as issues to consider during the bargaining process. Which action by the manager would be appropriate? 1. Leave the break room and not discuss with others what was heard. 2. Inform staff they are not to talk about their bargaining issues during work time or at the work site. 3. Issue a written warning regarding discussion of wages while on the job. 4. Tell nursing administration that a strike is likely.

Correct Answer: 2 Rationale 1: The manager may leave the break room but should address the issue of employees not discussing collective bargaining while at work or on the work site. Rationale 2: The manager should address the issue of employees not discussing collective bargaining while at work or on the work site. Rationale 3: It is not necessary to issue a written warning for discussion of wages. Rationale 4: Simple discussion of wages and benefits does not herald a strike.

Question 24 Type: MCSA A level III disaster has occurred and the hospital is receiving clients by ambulance and those who have walked in to the emergency department. The wife of a man who is critically injured screams, Why doesnt someone do something for my husband? He is dying! How should the nurse manager respond? 1. Maam, you should not be back here. You will have to leave. 2. Im so sorry, but your husbands injuries are very severe. We have to take care of the others first. 3. Is there someone who can stay with this woman? She is distraught. 4. He doesnt pass the triage screen for someone we can save.

Correct Answer: 2 Rationale 1: The manager should take measures other than just making the woman leave. Rationale 2: This is a kind statement of fact and is a good way to address this wife. Rationale 3: This is a true statement, but does not explain to the wife why her husband is not being cared for. Rationale 4: Even though this is a true statement, the wife will probably not understand what a triage screen is.

Question 17 Type: MCSA A manager is preparing to write a critical incident regarding a nurse who has voluntary absences for several scheduled shifts. What information should the manager determine first? 1. How many hours were missed per pay period? 2. What was the frequency and time period of the absences? 3. What was the reason for these absences? 4. Who did the nurse notify of the impending absences?

Correct Answer: 2 Rationale 1: The number of hours missed per pay period is interesting information, but is not the most critical statistic for this critical incident. Rationale 2: The number of absences and the time periods of the absences are critical pieces of information for the critical incident documentation. Rationale 3: It is already clear that these absences were excessive and voluntary, so a critical incident form will be completed. The reason why the absences occurred is of secondary importance. Rationale 4: It is important to determine if the nurse followed policy when notifying the institution about the absences, but this is not the most critical information.

Question 13 Type: MCSA With the current health care industry focus on managed care, nurses must be more cost-conscious. Which option is an example of a nurse being cost-conscious? 1. The nurse reviewing the clients itemized bill each day 2. The nurse's decision to use fewer supplies when changing a dressing 3. The nurse manager reviewing client costs on a daily basis 4. The nurse manager requesting that the materials management director obtain quotes for less expensive items

Correct Answer: 2 Rationale 1: The nurse and the nurse manager do not have time nor is it their responsibility to review a client's hospital bill. Rationale 2: The nurse can use resources wisely to decrease costs to the client and the hospital. Rationale 3: The nurse manager does not review client costs on a daily basis. Rationale 4: The materials management director does look for less expensive materials to provide client care supplies and hospital supplies, but it is not the responsibility of the nurse manager to direct this person's work.

Question 5 Type: MCSA During a 3-month period, a nurse has missed work on six occasions due to unreliable child care. Another nurse has missed 10 days due to a minor foot surgery. How should the manager categorize the reliability of these nurses? 1. The nurse with the voluntary absence is more reliable. 2. The nurse with involuntary absences is more reliable. 3. It depends on other factors such as job performance when present. 4. Both nurses are unreliable due to excessive absences during this time period.

Correct Answer: 2 Rationale 1: The nurse who had voluntary absence had fewer days absent but could have controlled the absences by obtaining reliable transportation and back up child care. Rationale 2: The nurse with the involuntary absence is more reliable because the absence is less frequent and due to something outside the nurses control. Rationale 3: The nurse who voluntarily misses work on six occasions in a 3-month period is not a reliable employee even if job performance when at work is good. Rationale 4: Involuntary absences do not affect reliability in the same manner as voluntary absences. Typically involuntary absences for surgery are scheduled in advance and the manager can schedule for the absence.

Question 17 Type: MCSA A disaster planning task force has been asked to focus on communication. Which instruction should this group provide to nursing staff? 1. Limit your communication to physicians and other nurses. 2. Be certain to maintain the client tracking system. 3. All communication with law enforcement will be conducted through the public resources officers. 4. Communication is likely to follow the standard daily pattern.

Correct Answer: 2 Rationale 1: The nurse will be communicating with multiple people in multiple roles during the disaster. Rationale 2: A system to track the clients presence in the facility should be a part of the disaster plan. It is essential to maintain this system so that victims can be accounted for by rescuers. Rationale 3: The nurse may be communicating directly with law enforcement officers who bring victims to the hospital. All status reports should be given through PR. Rationale 4: Communication is very unlikely to be like the daily pattern.

An emergency department (ED) client is demanding pain medication and threatening to harm staff if they do not provide it. The ED physician calmly continues to ask the client about the level and location of pain as the nurse steps away and notifies security. What is the physician attempting to do by asking these questions? 1. Distract the client. 2. De-escalate the situation. 3. Determine the clients real reason for seeking treatment. 4. Assess the clients level of pain.

Correct Answer: 2 Rationale 1: The physician's tactics may distract the client but this is not the reason for this action. Rationale 2: The physician's tactics is an attempt to de-escalate the situation until security arrives. Rationale 3: Determining the real reason the client is seeking treatment is not the current priority. Rationale 4: Assessing the level of pain is not the current priority.

Question 15 During an interview the candidate informs the manager of a difficult experience between a client and a physician. The nurse had to negotiate between an unhappy client and a difficult physician. Which notation by the manager would describe this situation? 1. The candidate has good initiative. 2. The candidate has good conflict resolution skills. 3. The candidate is a client advocate. 4. The candidate is adaptable.

Correct Answer: 2 Rationale 1: The question does not focus on the candidate's degree of adaptability or initiative. Rationale 2: The candidate used good negotiation skills and a conflict was resolved between a client and a physician. Rationale 3: One may assume the nurse acted as a client advocate but the question does not provide enough information to choose this answer with certainty. Rationale 4: The question does not focus on the candidate's degree of adaptability or initiative.

Question 15 Type: MCSA During an interview the candidate informs the manager of a difficult experience between a client and a physician. The nurse had to negotiate between an unhappy client and a difficult physician. Which notation by the manager would describe this situation? 1. The candidate has good initiative. 2. The candidate has good conflict resolution skills. 3. The candidate is a client advocate. 4. The candidate is adaptable.

Correct Answer: 2 Rationale 1: The question does not focus on the candidates degree of adaptability or initiative. Rationale 2: The candidate used good negotiation skills and a conflict was resolved between a client and a physician. Rationale 3: One may assume the nurse acted as a client advocate but the question does not provide enough information to choose this answer with certainty. Rationale 4: The question does not focus on the candidates degree of adaptability or initiative.

A staff nurse finds a newly licensed, newly hired staff nurse crying in the break room halfway through a shift. The new nurse says, I am just not getting this. I had no idea nursing would be this hard. The experienced nurse says, Reality shock is terrible, but you will get through it. What does the nurse mean by reality shock? 1. A period of time when it becomes clear the new nurse is not able to function as a registered nurse 2. A period of surprise and disequilibrium about the nursing role 3. A period when expectations of the role are unclear 4. A period of time when managers determine if the new nurse is a good fit for the profession of nursing

Correct Answer: 2 Rationale 1: There is no indication that the new nurse cannot eventually function as a registered nurse. Rationale 2: Reality shock is the period of transition from a protected student role to a professional role in which the nurse is responsible and accountable for the care of several clients. Rationale 3: Being unclear about the role is role ambiguity. Rationale 4: It would be unfair for the manager to determine the nurses fitness for the profession during reality shock.

Question 25 Type: MCSA The newly hired nurse manager is involved in the first budgetary cycle since being hired. The manager lists some capital equipment needs and is surprised when they are not available for staff use two months after the request. What is the reason for this? 1. The equipment was not approved by the mangers supervisor. 2. The budgetary cycle takes up to 1 year to occur. 3. The hospital has experienced a downturn in revenue and it not fulfilling promises. 4. The nurse manager failed to complete the correct request.

Correct Answer: 2 Rationale 1: There is no indication that the request was not approved, just that it has not yet been filled. Rationale 2: The budgetary cycle of a large organization typically takes about 1 year to be completed. If the new manager sent in a request for the next budget, it may be 12-18 months before the equipment arrives. Rationale 3: There is no indication that the hospital is not fulfilling budgetary promises, just that the request has not yet been filled. Rationale 4: There is no indication that the manager made an error, just that the request has not yet been filled.

Question 6 The hospital operator announced over the paging system, Dr. Strong, fourth floor, A-wing, Dr. Strong, fourth floor, A-wing. A newly hired nurse asks another nurse, who is Dr. Strong? The nurse replies, this is the announcement that alerts security there is violent behavior on that unit. Which statement would be an appropriate report to this unit's manager? 1. Our new nurse does not know what Dr. Strong means. 2. There was an incident in which a staff person did not know what Dr. Strong meant. Could we have an in-service on this policy? 3. The operator paged a Dr. Strong and we didn't know what to do. 4. Why do they use Dr. Strong when there is trouble? They should just call for help.

Correct Answer: 2 Rationale 1: This statement does not offer any plan for correction. Rationale 2: Since this is a newly hired nurse, one would expect that the Dr. Strong page would have been covered in orientation. Since this nurse did not understand the meaning of the page, it is likely others will not. An in-service is needed. Rationale 3: The newly hired nurse did not know what to do, which indicates that others in the same orientation may also be uninformed. The more experienced nurse did know what the page meant. Rationale 4: The nurse needs to understand the policy, not make comments on its worth.

Question 12 Type: MCSA A nurse manager is leading an education session regarding disaster triage for emergency department nurses. Which statement should the manager include in this instruction? 1. Follow your current triage system. 2. Your triage system will be reversed during a disaster. 3. Triage is not necessary during disasters. 4. Your triage system will basically be first-come, first-served.

Correct Answer: 2 Rationale 1: Triage in a disaster is vastly different than normal triage. Rationale 2: Triage is reversed during a disaster. The least injured clients are seen first. Rationale 3: Triage is essential during disasters. Rationale 4: Triage follows a designated plan and is not first-come, first-served.

A chief nurse officer (CNO) is contacted by the organizations supervisor on a Saturday night regarding a problem in the hospital's emergency department. The supervisor describes an incident in which an orderly was assaulted. Why is the CNO not surprised about this report? 1. This is a typical occurrence in the emergency department. 2. Health care violence is more likely to occur in emergency departments. 3. Health care violence generally occurs on the weekend. 4. Health care violence is likely to occur on the night shift.

Correct Answer: 2 Rationale 1: Violence should not be characterized as a typical or expected aspect of the workplace. Rationale 2: In health care, violence is more likely to occur in psychiatric settings, emergency departments, waiting rooms, and geriatric units. Rationale 3: Violence can occur on any day. Rationale 4: Violence can occur at any time of day.

A problem has arisen on a unit whose nursing staff is composed primarily of members of Generation X. Which strategies should the nurse manager employ to get staff input into solving this problem? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Schedule a staff meeting for discussion of the problem and its possible solutions. 2. Post a notice on the bulletin board explaining the issue. 3. Ask nurses individually for input. 4. Develop a possible solution and share it with nurses in a formal meeting. 5. Ask for input via text message and promise to respond to texts immediately.

Correct Answer: 2,3 Rationale 1: Generation X members do not like group problem solving and decision making. This is more the style of baby boomers. Rationale 2: Generation X members would be more likely to read the information, formulate an opinion, and share it with the manager. They like decisions to be made without unnecessary discussion. Rationale 3: Generation X members do not like unnecessary discussion, so asking for input individually would be a good strategy. Rationale 4: Traditionalists are more likely to respond to a suggestion from someone higher in the chain of command. They also tend to be more formal. Rationale 5: Generation Y is more likely to want immediate feedback from e-mails or text messages.

A nurse manager who is retiring is helping the new manager learn about the position. As part of this education, the current manager has the new manager make all decisions that can be made under certainty. What conditions will these decisions have in common? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. There is risk associated with the decision. 2. The alternatives are known. 3. The conditions of each alternative are clear. 4. Possible consequences of alternatives are not known. 5. The decision is complex and dynamic.

Correct Answer: 2,3 Rationale 1: With decisions made under certainty, there is little if any risk. Rationale 2: When a decision is made under certainty, the possible alternatives are known. Rationale 3: When a decision is made under certainty, the conditions surrounding possible alternatives are clear. Rationale 4: If possible consequences of alternatives are not known, the decision is being made under conditions of uncertainty. Rationale 5: Complex and dynamic decisions are those made under uncertainty.

What characteristics would cause the manager to classify an employee as marginal? Standard Text: Select all that apply. 1. The employee works only when client census calls for additional staff. 2. The employees work does not improve with coaching. 3. The employee just made an error for which discipline has already been done twice. 4. The employee has worked at the facility for less than 1 month. 5. The employee does not mix well with the other staff, but stays on the margins of the group.

Correct Answer: 2,3 Rationale 1: An employee who works only on a prn basis is not necessarily a marginal employee. Rationale 2: A marginal employee does not take instruction well. Rationale 3: An employee whose work does not improve after discipline is a marginal employee. Rationale 4: Length of employment has little to do with being classified as marginal. Rationale 5: Marginal does not mean staying at the margins of the social group.

A staff nurse on a busy outpatient surgery unit comes to the manager and says, I dont know what is going on. I just feel unsettled and anxious. How should the manager interpret this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse is trying to establish a problem for which days off will be necessary. 2. The nurse may be suffering from free-floating anxiety. 3. The nurse may be overstressed. 4. The nurse has compassion fatigue. 5. The nurse is about to experience post-traumatic stress disorder.

Correct Answer: 2,3 Rationale 1: There is no indication that the nurse is trying to make up an illness to get time away from work. Rationale 2: Free-floating anxiety is anxiety that seems to have many alternating causes. Rationale 3: Stress can cause these feelings of anxiety or fear. Rationale 4: Compassion fatigue has much more serious symptoms than anxiety. Rationale 5: There is no evidence of post-traumatic stress disorder.

Question 7 A hospitals safety committee has been asked to make recommendations to administration regarding methods to improve employee safety. Which suggestions should be made? Standard Text: Select all that apply. 1. Reserving parking spaces closest to the facility for staff 2. Security cameras throughout the facility 3. Curved mirrors in the corridors 4. Using restraints on all confused clients 5. Requiring all personnel to take physical self-defense training

Correct Answer: 2,3 Rationale 1: While isolated or unlit parking can be a safety concern, there is no reason that staff should have the parking next to the facility. There are also concerns for visitor and client safety to consider. Rationale 2: Instituting environmental controls such as security devices and curved mirrors are measures to ensure safety. Rationale 3: Instituting environmental controls such as security devices and curved mirrors are measures to ensure safety. Rationale 4: Just because a client is confused does not indicate a tendency toward violence or a need for restraints. Rationale 5: While all staff should be trained regarding violence, physical self-defense training is not practical for every staff member.

Question 2 Type: MCMA Health care providers are preparing for a worldwide outbreak of H1N1 influenza. How would this outbreak be classified in planning literature? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A man-made disaster 2. As a pandemic 3. As a health disaster 4. As a natural disaster 5. As an epidemic

Correct Answer: 2,3,4 Rationale 1: H1N1 occurs naturally and is therefore a natural disaster. Rationale 2: If H1N1 spreads around the world, it is a pandemic. Rationale 3: H1N1 that spreads around the world would be a health disaster. Rationale 4: H1N1 is naturally occurring and is therefore a natural disaster. Rationale 5: If the illness spreads around the world, it is considered a pandemic.

Question 26 Type: MCMA One of the areas of supervision defined by the National Labor Relations Board (NLRB) is independent judgment. Which nurses fall into this category? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A nurse who routinely reviews lab work and makes a clinical judgment of when to notify the physician 2. A nurse who works twice a month as charge nurse on an acute care unit 3. A nurse who makes team assignments as part of the charge nurse role 4. A nurse whose job includes choosing which assistants to place with which clients 5. A nurse who applies assessment findings when altering the plan of care for a client

Correct Answer: 2,3,4 Rationale 1: Routine clinical judgment in care of clients is not included in independent judgment. Rationale 2: If the nurse is regularly scheduled as charge nurse, the nurse is considered to be using independent judgment to match staff skills to client needs. Rationale 3: If the nurse is matching staff skills to client needs, independent judgment is being used. Rationale 4: If the nurse is matching employee skills with client needs, independent judgment is being used. Rationale 5: Using assessment findings to alter the plan of care is clinical judgment, not independent judgment in the context of collective bargaining.

Question 23 Type: MCMA Why is postdisaster follow-up an essential part of disaster planning? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. To assure staff members of their personal safety 2. To evaluate the performance of those involved 3. To initiate any improvements needed 4. To evaluate the overall effectiveness of the plan 5. To complete critical incident forms

Correct Answer: 2,3,4 Rationale 1: This is not the reason for the follow-up. Rationale 2: Evaluating the performance of those involved helps to identify areas of need. Rationale 3: Follow-up helps to identify areas where improvement is needed. Rationale 4: The plan itself should be evaluated for effectiveness. Rationale 5: This is not an appropriate use of critical incident forms.

A nurse manager has a strong belief in the value of certification for staff nurses. Unfortunately, only two staff members are certified. How could the manager encourage the remaining staff to seek certification? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Make it a job requirement. 2. Obtain grant monies to fund purchase of materials for certification. 3. Support those who are seeking certification with study sessions and helpful study hints. 4. Work with administration to obtain a salary adjustment for those who become certified. 5. Role-model the behavior by becoming certified.

Correct Answer: 2,3,4,5

A nurse manager looks through a file that contains information regarding critical incident reports filed within the past year. For which reasons does the manager review and use this information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. To increase leniency 2. To decrease the possibility of lawsuits by the employee being evaluated 3. To increase manager-employee communication 4. To decrease recency error 5. To increase the accuracy of the evaluation

Correct Answer: 2,3,4,5

A nursing supervisor warns the nurse manager, Having access to electronic communication is not always a blessing. How should the manager interpret this warning? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Electronic communication wastes more time than it saves. 2. The manager does not have to be physically present in the facility for communication to take place. 3. If not used effectively, electronic communication can prevent the manager from getting rest. 4. Along with a flatter organization and easy access, the nurse managers job responsibilities have increased. 5. In todays health care environment there is pressure to do more with less.

Correct Answer: 2,3,4,5 Rationale 1: Electronic communication can be a time waster, but if it is used effectively it save more time than it wastes. Rationale 2: The nurse manager is instantly available through cell phone or e-mail, but this is not always a positive. Easy availability allows nurses to avoid making decisions and the manager is never really off call. Rationale 3: If nurses have instant contact with the manager and are not taught to solve problems, the manager may be called at all hours and on days off. This prevents the manager from getting needed rest. Rationale 4: Job enlargement has occurred, which means the nurse manager has greater responsibility and more employees to supervise. One reason this can occur is there is easier access to the manager during off-duty hours. Rationale 5: There is a need to do more with less in health care. Electronic communication makes the potential work place much bigger than it was previously.

The nursing supervisor is planning an education session on collaborative communication between nurses and physicians. Which topics should be on this agenda? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Interdisciplinary respect 2. Understanding the role of the physician 3. Understanding the role of the nurse 4. Communication across disciplines 5. Active listening skills

Correct Answer: 2,3,4,5 Rationale 1: This topic is diffuse and hard to understand. More precise topics should be used. Rationale 2: Role understanding is essential to collaboration. It must include both roles. Rationale 3: Role understanding is essential to collaboration. It must include both roles. Rationale 4: Communication is the key to collaboration. Rationale 5: Listening is an essential part of communication.

The nurse manager is completing employee evaluations. Which practices should the manager use when doing these appraisals? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Appraising staff nurses every 18 to 24 months 2. Sharing the appraisal with staff nurses verbally and in writing 3. Requiring the staff nurse to sign the appraisal 4. Allowing the nurse to make written comments on the appraisal 5. Advising the nurse of the right to appeal the appraisal

Correct Answer: 2,3,4,5 Rationale 1: A staff nurse should be appraised at least every 12 months. Rationale 2: The appraisal should be shared with the staff nurses both in writing and face-to-face discussion. Rationale 3: The nurse should sign the appraisal to indicate that it has been received. Rationale 4: The nurse should be allowed to make written comments on the appraisal. Rationale 5: The nurse does have the right to appeal the findings of the appraisal and should be advised of this right.

Question 7 Type: MCMA A nurse is working with a hospital team to create an emergency response plan that will meet Joint Commission requirements. Which sections should be included in this plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A method to predict when a disaster will occur through close attention to news and weather reports 2. A method to recognize that a disaster is imminent or occurring with plans to reduce the disasters impact 3. A plan whereby policies and procedures as well as equipment and personnel are in place to handle disasters 4. Policies and procedures that operationalize actual activities during the disaster 5. Policies and procedures describing what will occur immediately after the disaster

Correct Answer: 2,3,4,5 Rationale 1: It is not possible to predict when a disaster will occur. Rationale 2: This section of the plan would address mitigation of the disaster. Rationale 3: This section would be titled Preparedness. Rationale 4: This is the response section. Rationale 5: This is the recovery section.

Question 21 Type: MCMA A nurse executive is assigned to a task force working on a surge system for the hospital in case of a disaster. This group should write strategies to cover which procedures? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Post-incident follow-up 2. Supplies 3. Physical space 4. Management infrastructure 5. Personnel

Correct Answer: 2,3,4,5 Rationale 1: Post-incident follow-up is not a part of surge strategy. Rationale 2: How to get supplies, how to know how many supplies are on hand, and how to distribute supplies are all part of a surge strategy. Rationale 3: Allocation of physical space is a part of surge strategy. Rationale 4: Whom to notify, how to communicate with community officials and media, and how to notify staff are all part of surge strategy concerning management infrastructure. Rationale 5: How to notify staff of the disaster, how to allocate staff in a disaster, how to allocate and manage volunteers, and how to provide for all these personnel is a part of surge strategy.

Question 22 The hiring process to fill a nursing position has been slowed because the human resources department is involved in a recruitment effort for laboratory positions. A staff nurse says, why do we have to wait on HR? Why can't we just hire a nurse? What rationale does the nurse manager provide for waiting until HR can be involved in filing the nursing position? Standard Text: Select all that apply. 1. HR makes all the final hiring decisions. I just suggest the candidate I would like to have to fill the job. 2. HR will screen the applicants for us so we don't waste time interviewing people who are not qualified. 3. HR makes certain that we are not doing anything illegal as we interview for this position. 4. We can't hire a nurse until HR has done a criminal background check. 5. HR has to check to be certain that the applicant has a valid license before we can offer the job.

Correct Answer: 2,3,4,5 Rationale 1: The final hiring decision is that of the manager with input from nursing supervisors as needed. Rationale 2: HR conducts the initial screening. Rationale 3: HR is responsible for assuring legal hiring practices are followed. Rationale 4: HR is generally responsible for conducting criminal background checks. Rationale 5: HR does confirm licensure.

Question 22 Type: MCMA The hiring process to fill a nursing position has been slowed because the human resources department is involved in a recruitment effort for laboratory positions. A staff nurse says, Why do we have to wait on HR? Why cant we just hire a nurse? What rationale does the nurse manager provide for waiting until HR can be involved in filing the nursing position? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. HR makes all the final hiring decisions. I just suggest the candidate I would like to have to fill the job. 2. HR will screen the applicants for us so we dont waste time interviewing people who are not qualified. 3. HR makes certain that we are not doing anything illegal as we interview for this position. 4. We cant hire a nurse until HR has done a criminal background check. 5. HR has to check to be certain that the applicant has a valid license before we can offer the job.

Correct Answer: 2,3,4,5 Rationale 1: The final hiring decision is that of the manager with input from nursing supervisors as needed. Rationale 2: HR conducts the initial screening. Rationale 3: HR is responsible for assuring legal hiring practices are followed. Rationale 4: HR is generally responsible for conducting criminal background checks. Rationale 5: HR does confirm licensure.

A nurse has been in practice for 14 years and has worked in three different departments in the hospital. The nurse is a member of a professional organization and is considering running for an office next year. According to Shirey, this nurse is in which career phase? 1. The promise phase 2. The adolescent phase 3. The momentum phase 4. The harvest phase

Correct Answer: 3

The supervisor is teaching managers about the use of critical incidents as part of the evaluation process. What information should the supervisor share? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Our primary focus for using these notes is to find out who is doing a poor job. 2. Using these notes will help you identify little problems before they become big problems. 3. You can expect some negative reactions from staff. 4. It is okay to tell your staff that you cannot remember all the details of each encounter for evaluation and the notes will help. 5. Having these notes will help you feel more confident in your evaluation of staff.

Correct Answer: 2,3,4,5 Rationale 1: The focus is on improving accuracy of the performance review. Rationale 2: Using notes forces the manager to deal with problems when they begin, rather after they have caused additional issues to arise. Rationale 3: When note taking is introduced, people tend to be suspicious and to react negatively. Rationale 4: Managers should be encouraged to be honest with staff about the note-taking strategy. Rationale 5: Having performance notes written across the evaluation period will help the manager have greater confidence in the evaluation process.

Question 13 Type: MCMA Hospital management is brainstorming ways to reduce absenteeism. Which suggestions from this session deserve further investigation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I think we should define excessive absenteeism by total time lost instead of absence frequency. 2. Lets offer a salary increase for those with good attendance. 3. Why not include attendance as part of the employee performance appraisal? 4. I dont think we are enforcing the absence policies we have now. That is the logical place to start. 5. We need to start at the top and be certain all of our management employees maintain good attendance.

Correct Answer: 2,3,4,5 Rationale 1: Total time lost is not as sensitive an indicator of excessive absenteeism as absence frequency. For example, an employee might miss 30 days of work due to a scheduled surgery for which the manager could make scheduling adjustments. Another employee could miss a total of 30 days due to oversleeping, car trouble, or just deciding not to come to work. The difference in impact on the unit is obvious. Rationale 2: The idea of offering a salary increase should be further investigated. Rationale 3: The idea of using attendance as part of the employee performance appraisal may work, especially if the appraisal is tied to merit raises. Rationale 4: If absence policies currently in place are not being followed, employees develop the idea that absences are not a serious issue. Rationale 5: Employees model what they see in managerial staff. If the management level employees do not have good attendance, the staff begins to believe that absences are not a problem. Global Rationale:

Question 3 A hospital administrator has attended a conference on bullying and wishes to address the most likely bullies in the organization. Whom would the administrator invite to the first meeting about bullying behaviors? Standard Text: Select all that apply. 1. Nursing assistants 2. Physicians 3. Managers 4. Office personnel 5. Senior nurses

Correct Answer: 2,3,5

Question 14 Type: MCMA Which statements would the nurse manager interpret as indicating a nurse understands the critical thinking skills necessary for disaster management? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. It is just like critical thinking in the emergency department or critical care unit, only done faster. 2. The nurses prioritization will be different in a disaster. 3. Clinical judgment skills will be an essential part of nursings contribution to disaster management. 4. Decision making will basically be done by following established protocols. 5. The nurses abilities will make the difference in successful management of a disaster.

Correct Answer: 2,3,5 Rationale 1: Critical thinking in disasters is different than in normal health care situations. For example, the triage system is reversed. Rationale 2: Normal prioritization will not be helpful in a disaster. Rationale 3: The nurses clinical judgment will be essential in making rapid assessments and treatment decisions. Rationale 4: Disaster situations cannot be scripted with protocols. Decisions must be made quickly and accurately based upon the situation and may change in a moment-to-moment fashion. Rationale 5: Nursing will be a big part of management of a disaster and good nursing skills will make a difference.

Question 15 Type: MCMA A grievance has been filed against a hospital. Which statement by the nurse executive reflects common reasons for grievances? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurses want more benefits than specified in the contract we just signed. 2. I think there is a misunderstanding of one of the terms of the contract. 3. I think this grievance is based on a term in the old contract that is not included in the new contract. 4. The nurses want higher wages because the other hospital in town just raised their pay scale. 5. This contract just is not going to work. We need to renegotiate.

Correct Answer: 2,3,5 Rationale 1: If the benefits provided are those specified in the contract, there are no grounds for grievance. Rationale 2: Misunderstandings are common causes of grievances. Rationale 3: Lack of familiarity with the contract is a common reason for a grievance. Rationale 4: It the nurses want higher wages, the contract should be renegotiated. A grievance is not indicated. Rationale 5: An inadequate agreement is a common reason for a grievance.

Although the postoperative assessment of a client reveals no abnormalities, the nurse believes the clients condition is deteriorating and orders frequent vital signs. This intervention was made on the basis of which type of problem solving? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Experimentation 2. Intuition 3. Satisficing 4. Past experience 5. Trial-and-error method

Correct Answer: 2,4 Rationale 1: Experimentation involves testing a theory to produce a prediction. Rationale 2: Intuition and past experiences enable the expert nurse to make clinical judgments based on wisdom, sensitivity to the client, and a gut feeling that a change in the client is imminent. Rationale 3: Satisficing involves choosing a solution to meet minimum standards of care. Rationale 4: Intuition and past experience enable the expert nurse to make clinical judgments based on wisdom, sensitivity to the client, and a gut feeling that a change in the client is imminent. Rationale 5: The trial-and-error method is not based on prior experience; rather, one approach after another is tried until the problem is solved.

A newly formed task force is addressing the prevention of violence in the health care organization. Which group of employees is most likely to experience violence? Standard Text: Select all that apply. 1. Private practice physicians 2. Nurses working in a geriatric unit 3. Nurses working in a pediatric clinic 4. Nurses whose work space includes large waiting rooms 5. Technicians working in the medical laboratory

Correct Answer: 2,4 Rationale 1: Physicians in private practice can control their practice environment. Physicians are not in the group that experiences the most violence. Rationale 2: Geriatric units are among the sites in which violence is most likely to occur. Rationale 3: Clinics are among the sites in which violence is least likely to occur. Rationale 4: Waiting rooms are among the most common sites of health care violence. Rationale 5: Medical laboratories are isolated areas and are not among the places where health care violence commonly occurs.

Question 23 Type: MCMA Which job responsibilities indicate that a nurse has supervisory capacity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse makes clinical judgments about client care. 2. The nurse assigns a nurse assistant to care for a team of clients. 3. The nurse discusses client care with the supervising physician. 4. The nurse hires staff to manage units. 5. The nurse retains responsibility for the actions of nurses assigned to provide client care.

Correct Answer: 2,4,5 Rationale 1: Both staff nurses and supervisory nurses make clinical judgments about client care. Rationale 2: If the nurse makes assignments to a nurse assistant, the nurse has supervisory capacity. Rationale 3: Both staff nurses and supervisors discuss client care with supervising physicians and other physicians. Rationale 4: Hiring staff to manage a unit is a type of assignment that indicates supervisory capacity. Rationale 5: If the nurse has responsibility for the actions of those to whom client care has been assigned, the nurse has supervisory capacity.

The nurse is talking to a client who has a history of aggressive outbursts. What strategies should this nurse use? Standard Text: Select all that apply. 1. When addressing the client, use powerful body language. 2. Remain calm and speak in a moderate tone. 3. Approach the client with an aggressive I'm in charge attitude. 4. Speak in simple terms. 5. Allow the client to speak.

Correct Answer: 2,4,5 Rationale 1: Powerful body language may be interpreted as threatening. Rationale 2: A calm manner and moderate tone are calming to the client. Rationale 3: Aggression or aggressive attitudes can escalate this client's hostility. Rationale 4: The nurse should use simple terms when talking to this client. Rationale 5: The client should be allowed to speak, and the nurse should respectfully listen.

Question 2 Type: MCMA Which information is an example of what should be included in the position description for the RNs who will staff a newly opened hospital unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Base salary is $22.00 per hour with a 10 percent shift differential for hours worked after 7:00 p.m. 2. Communicates changes in client condition to appropriate staff 3. Will accrue sick time at a rate of 4 hours per month 4. Reports directly to the nurse manager of the unit 5. Must maintain ACLS certification

Correct Answer: 2,4,5 Rationale 1: Salary is not included in this document. Rationale 2: Tasks required to carry out the duties involved in the position are included. Rationale 3: Benefit package is not a part of the position description. Rationale 4: The position description should indicate the person to whom the employee will report. Rationale 5: Professional qualifications for the position are included in this statement.

Question 2 Which information is an example of what should be included in the position description for the RNs who will staff a newly opened hospital unit? Standard Text: Select all that apply. 1. Base salary is $22.00 per hour with a 10 percent shift differential for hours worked after 7:00 p.m. 2. Communicates changes in client condition to appropriate staff 3. Will accrue sick time at a rate of 4 hours per month 4. Reports directly to the nurse manager of the unit 5. Must maintain ACLS certification

Correct Answer: 2,4,5 Rationale 1: Salary is not included in this document. Rationale 2: Tasks required to carry out the duties involved in the position are included. Rationale 3: Benefit package is not a part of the position description. Rationale 4: The position description should indicate the person to whom the employee will report. Rationale 5: Professional qualifications for the position are included in this statement.

Question 2 Type: MCMA The nurses of a hospital have given notice of their desire to unionize. The nurse executive is meeting with all nurse managers to discuss their role. Which information should the executive provide for these managers? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. We need to stop this if at all possible. I am counting on you to discourage nurses from joining the union. 2. If the nurses on your unit want to organize, do not interfere. 3. You cannot say anything about the union, but your actions can speak for you. 4. We are not going to participate in this. 5. I will keep you posted as we move through this process.

Correct Answer: 2,5 Rationale 1: Encouraging or discouraging union membership by a manager is an unfair labor practice. Rationale 2: Interference with the right to organize is an unfair labor practice. Rationale 3: Any act of domination or indication of preference regarding the union is an unfair labor practice. Rationale 4: Refusal to bargain collectively is an unfair labor practice. Rationale 5: The managers must be kept apprised of the process.

A baccalaureate nurse has been invited to join Sigma Theta Tau International (STTI). While trying to decide about taking the offer, the nurse asks a member about the organization. Which option reflects the best reason to join a group such as this? 1. It offers the privilege of joining a distinguished group of professionals. 2. It offers the privilege of participating in an organization. 3. It offers the ability to network and learn while serving the organization. 4. It offers the ability to join the American Nurses Association.

Correct Answer: 3

A newly promoted nurse manager is overwhelmed by the amount of paperwork that must be submitted to the director. The nursing unit is very busy and is short staffed, so the manager also takes a client assignment. This additional work makes the paperwork load even more daunting. Which statement is the most important lesson for this manager to learn? 1. A managers first priority is client care. 2. A managers first priority is the nursing staff. 3. The job requires the nurse to adjust, respond to change, and remain flexible. 4. The paperwork is not important.

Correct Answer: 3

The nurse asks the nurse manager if he can go home early because the census is low. When the request is denied, the nurse states, I dont understand why I cant leave early. I will use vacation time and this will help minimize personnel costs for the shift. This statement is an example of which technique of influencing the supervisor? 1. Fogging 2. Negative assertion 3. Negative inquiry 4. Compromise

Correct Answer: 3 Rationale 1: Fogging is a technique used when the person is in partial agreement with what was said. Rationale 2: Negative assertion involves some acceptance of blame for what was said. Rationale 3: Negative inquiry is a statement of I dont understand. Negative inquiry is an effective technique, provided the person to whom it is directed does not become defensive or distraught. Rationale 4: Compromise implies that an agreement has occurred between the nurse manager and the nurse.

The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate? 1. Lateral communication 2. Downward communication 3. Diagonal communication 4. Grapevine communication

Correct Answer: 3 Rationale 1: Lateral communication involves discussion among individuals at the same hierarchical level (e.g., all nurse supervisors). Rationale 2: Downward communication involves direction given by management to the staff. Rationale 3: Diagonal communication involves dialogue among individuals at different hierarchical levels (e.g., staff nurses to chief executive officer of nursing). Rationale 4: Grapevine communication is an informal channel among individuals at all hierarchical levels and has the potential to generate misinformation.

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability? 1. When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings. 2. Tell staff members that they must present one opinion regarding the solutions they desire. 3. Demonstrate a genuine desire to find our why there is dissention. 4. Develop tunnel vision when it comes to problems on the unit.

Correct Answer: 3 Rationale 1: Managers should not assume that only one opinion can be voiced and that others will be silent. Rationale 2: Managers should not assume that only one opinion can be voiced. Rationale 3: Good managers start out with a commitment to find out why others disagree. Rationale 4: Tunnel vision makes it difficult to see things from another perspective and will not encourage staff to avoid preconceived ideas.

The nursing group has been charged with the task of solving a patient care problem on the units. Which step should this group take first in this process? 1. Investigate what has already been tried to solve the issue. 2. Brainstorm about potential solutions. 3. Gather information to define the problem. 4. Categorize information in order of reliability.

Correct Answer: 3 Rationale 1: Once the problem has been identified, the group would then look at solutions that have already been tried. Rationale 2: Brainstorming is used to develop solutions after information about the problem is analyzed. Rationale 3: Problem solving begins with collecting the facts, which provides clues to the scope and solution of the problem. Rationale 4: Information cannot be sorted into an orderly arrangement until it has been collected.

The nurse manager has several tasks that need to be accomplished. Which task is the manager likely to do first? 1. A large job that holds little interest to the manager 2. A difficult task that is going to require several days to complete 3. A task that has been assigned by the supervisor instead of a task that the manager thinks will benefit the unit 4. A task that will have little impact on the unit

Correct Answer: 3 Rationale 1: People tend to do small jobs before large jobs and to do interesting things first. Rationale 2: People tend to do easier things first, especially if they can be completed quickly. Rationale 3: People tend to respond to the demands of others before demands from themselves. Rationale 4: People work on the basis of consequences to the group.

The nurse manager is writing annual evaluations for each nurse. In order to promote professional development, it is vital for the nurse manager and nurse to become involved in which activity? 1. Personal organization 2. Priority setting 3. Goal setting 4. Limit setting

Correct Answer: 3 Rationale 1: Personal organization is the result of clearly defined priorities based on well-defined, measurable, and achievable objectives. Rationale 2: Goals must first be identified and set before priorities can be set. Rationale 3: Goal setting helps to relate current behavior, activities, or operations to the organizations or the individuals long-range goals. Rationale 4: Limit setting is trying to keep a person in line and trying to shape behavior.

Which action by the nurse manager is a demonstration of satisficing? 1. The nurse manager works with the staffing schedule until all requested days off are honored. 2. The nurse manager reposts a job opening because no applicants were a good fit for the current unit staff. 3. The nurse manager agrees with a proposed budget that does not provide badly needed new client beds. 4. The nurse manager insists on firing a nurse who is chronically late to work.

Correct Answer: 3 Rationale 1: Satisficing would not involve extra effort to honor requested days off. Rationale 2: If the nurse manager was satisficing, someone would be hired, even if the fit was not good. Rationale 3: This is an example of satisficing. An example of not satisficing would be the nurse manager not agreeing with the budget until funding for the beds was provided. Rationale 4: A nurse manager who is satisficing would provide continued counseling, work with the nurse, make excuses, and retain the nurse on staff.

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential? 1. Obtain funding for a simulation mannequin. 2. Write standardized scripts for volunteers who will portray clients. 3. Add more information to existing care plans as the study unfolds. 4. Assign client care debate topics to teams of three or four students.

Correct Answer: 3 Rationale 1: Simulation mannequins are not essential for problem-based learning. Rationale 2: It is not essential to have a person who portrays a client in order to conduct problem-based learning. Rationale 3: Problem-based learning exists when students are exposed to what comes next in a case study. Additional information is revealed as the case study progresses. Rationale 4: Debates are a way to encourage innovation but are not essential for problem-based learning.

The nurse manager has instituted a policy of sending information to the staff via e-mail. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication? 1. Using text messaging instead of e-mailing 2. Requiring a return e-mail from everyone reading the information 3. Being certain that e-mails go only to the intended recipients 4. Sending all e-mails with a message line that says Important

Correct Answer: 3 Rationale 1: Text messaging can make the problem worse as it implies the need to respond quickly. Rationale 2: Having everyone send a return e-mail will set the nurse manager up for an onslaught of messages that are really not important. Rationale 3: E-mail communication is fraught with difficulties. The best of these options is to be certain that e-mails go only to the intended recipients. The use of reply to all or distribution lists is convenient, but can result in sending the e-mail to persons whom it does not affect. When this happens, people begin to ignore e-mail. Rationale 4: Sending the message line Important with each e-mail is much like crying wolf, and recipients will soon realize that the term Important is meaningless.

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use? 1. Political decision-making model 2. Experimentation process 3. Rational decision-making model 4. Trial-and-error method

Correct Answer: 3 Rationale 1: The premise of the political decision-making model is that decisions align with the interests of powerful stakeholders such as hospital boards and regulatory bodies. Rationale 2: Experimentation involves the use of a pilot project to test the effectiveness of a solution. Rationale 3: The rational decision-making model is a series of steps that managers take to make logical, rational choices that maximize the achievement of successful outcomes. Rationale 4: The trial-and-error method is used by inexperienced managers and involves the application of one solution after another to improve a problem.

Which example represents a qualifier that may interfere with the message to be communicated? 1. Please notify me when this task is complete. 2. Are you satisfied with the care you are receiving? 3. I hate to bother you with this, but we have a problem. 4. How can I help you solve your issues with this physician?

Correct Answer: 3 Rationale 1: This is a direct command or request and does not contain a qualifier. Rationale 2: This is a valid inquiry that does not include a qualifier. Rationale 3: Qualifiers are often used as entry statements into important discussions, but they can interfere with the message being communicated. This qualifier (I hate to bother you) sets up the receiver of the message to feel bothered. Qualifiers also reveal a lack of confidence in the sender. Rationale 4: This is a valid inquiry and does not include a qualifier.

After several near-incidents during procedures, the nurse manager is increasingly concerned about how nursing staff communicates with physician staff. Which advice from the manager would be most beneficial to the nursing staff? 1. Dont forget, you are just as good as they are. 2. Physicians just dont listen as well as nurses. 3. Lets review the steps of the procedures that we know are the biggest problems. 4. Im going to listen to the physicians, but I think most of the problem lies with them, not the nurses.

Correct Answer: 3 Rationale 1: This statement sets up an us against them mentality. This mindset does not support respect for the physicians and could make communication more difficult. Rationale 2: This statement sets up an us against them mentality. This mindset does not support communication. Rationale 3: The nurse manager should ensure that the nursing staff is competent in the procedures that are causing problems by reviewing the steps of the procedures with them. Rationale 4: The preconceived notion that the problems are the fault of the physicians would make open and honest communication more difficult.

at the beginning of a brainstorming session, the manager lists the rules to be followed. Which rule should be included and enforced? 1. Do not suggest any solution that is prohibitively expensive. 2. Suggest only ideas that the group has not already tried. 3. Do not critique any ideas presented. 4. Limit the session to the first 15 ideas.

Correct Answer: 3 Rationale 1: While all organizations are governed by a budget, what is prohibitive to one committee member may not be so to another. All solutions should be expressed. Rationale 2: Sometimes an old solution is workable. Rationale 3: Brainstorming is for idea generation only. Idea critique will follow in another session. Rationale 4: The idea of brainstorming is to generate lots of ideas quickly. It would be better to limit the time than to limit the number of ideas.

The nurse executive and the human resources manager of a hospital meet to discuss the recent increase in nursing turnover. Which statement reflects the best source of information about this increase? 1. What have the exit interviews shown as reasons for the resignations? 2. Were the reports from nurse managers on resignations completed accurately? 3. What are the reasons given in the survey mailed out 6 weeks after resignation? 4. Has the human resources staff been making telephone calls to employees when they turn in their resignation?

Correct Answer: 3 Rationale 1: Although an exit interview is usually done, it may not be the most effective method of evaluating the employees satisfaction. An employee may not be fully truthful if he or she intends to use the previous employer as a reference for a future job. Rationale 2: The nurse manager may or may not be aware of the reasons for nurses leaving their positions and may have a bias toward an unhappy employee. Rationale 3: A survey mailed weeks after the employee resignation may be the most effective method to measure nursing turnover. Several weeks later an employee may be in a new job, which could allow for a more honest reflection on reasons for leaving the previous position. Rationale 4: A telephone call from someone in human resources has the same limitations as the person-to-person exit interview.

Question 10 Type: MCSA A nurse educator is asked by the chairperson of the department to submit a list of equipment that could be used to meet the departments goals. The list includes projectors, computers, office supplies, and computer-assisted programs. How would the educator categorize the materials? 1. As an expense 2. As part of revenue 3. As part of the capital budget 4. As part of the operating budget

Correct Answer: 3 Rationale 1: An expense budget is a comprehensive budget that lists salary and nonsalary items that reflect patient care objectives and activity parameters for the nursing unit. Rationale 2: A revenue budget is a projection of expected income for a budget period based on volume and mix of patients, rates, and discounts. Rationale 3: A capital budget is a component of the budget plan that includes equipment and renovations needed by an organization in order to meet long-term goals. Rationale 4: An operating budget is the organizations statement of the expected revenues and expenses for the upcoming year.

Question 21 Type: MCSA The manager tells a potential nurse hire that the organization is a closed shop organization. The nurse asks for clarification. Which response by the manager is most accurate? 1. A closed shop is an organization in which union representation and collective bargaining practices are not discussed. 2. It is a term used to describe the collective bargaining practices in this state. 3. It means you are required to join the union if you accept this position. 4. You are required to sign a statement stating you received information regarding union membership.

Correct Answer: 3 Rationale 1: Closed shop does not refer to where union activities can be discussed. Rationale 2: While the term closed shop is used to describe collective bargaining practices in the hospital, it does not necessarily pertain to the whole state. Rationale 3: A closed shop is a business in which union membership is a precondition of employment. Rationale 4: The requirement extends further than just signing a statement that information was received.

Question 30 Type: MCSA The nurse works in a federal hospital that is beginning the collective bargaining process with nurses. The nurse is disappointed to discover that which concern cannot be addressed in negotiations? 1. Work hours 2. Job responsibilities 3. Wages 4. Conditions of client care

Correct Answer: 3 Rationale 1: Conditions of work, such as work hours, can be negotiated. Rationale 2: Job responsibilities can be negotiated. Rationale 3: Wages cannot be negotiated in federal institutions. Rationale 4: Conditions of client care can be negotiated.

Question 20 Type: MCSA An ICU manager is discussing a nurses frequent absences and tardiness, which the nurse explains results from unreliable child care. The nurse states, None of the other nurses mind if I am late or have to miss a shift. My kids are important to me. Id do the same for any of them. This is an example of which situation? 1. Enriched job environment 2. Organizational practices 3. Absence culture 4. Generational differences

Correct Answer: 3 Rationale 1: Enrichment of the job environment makes the job challenging and rewarding, which encourages employee attendance and participation. Rationale 2: Organizational practices are such things as on-site child care that can influence an employees motivation to work. Rationale 3: Absence culture on this unit is tolerant of absences. Rationale 4: While there may be some differences in how generations view punctuality and attendance, it is not clear that is an issue in this situation.

A nurse manager notes that staff is struggling with caring for an increased client load while a new management system is being implemented. What managerial action would help reduce this stress? 1. Asking a nursing faculty friend to use the unit for a student clinical 2. Hiring two newly licensed nurses for each shift 3. Asking for nurse input into decisions that directly affect care 4. Instituting a method of shift rotation that increases staff on each shift

Correct Answer: 3 Rationale 1: Helping to manage and supervise students is stressful for many nurses. Rationale 2: Helping to orient newly licensed nurses is stressful for many nurses. Rationale 3: Involving staff in decision making is one way to identify and reduce stress. Rationale 4: Working rotating shifts is very stressful to many nurses.

Question 27 Type: MCSA A valued longtime nursing employee says to the manager, Im so tired of all the politics on this unit. Im thinking about retiring. What should be the mangers response? 1. Ive just got 3 more years and I can retire. I cant wait. 2. I know, but I cant do anything to change the situation. 3. Id hate to lose you, but have you thought about transferring to a different unit? 4. Will you stay if I can get you a raise?

Correct Answer: 3 Rationale 1: If the manager wishes to retain this employee, a statement about wanting to retire is not prudent. Rationale 2: The manager is not offering this nurse any alternative except that the politics will continue. Rationale 3: The manager has offered the possibility of lateral transfer to this employee. It will not keep the employee on the managers unit, but will keep the employee in the organization. Rationale 4: Money might be enough to entice the employee to stay, but it is not the best option offered.

Question 20 Type: MCSA During discussion about the hospitals disaster plan, the administrator says, I am concerned about our current surge capacity. How should the members of the group interpret this concern? 1. The administrator is worried about the ability of the hospitals electrical system to handle the power fluctuation common during physical disasters. 2. The administrator is concerned that flood waters following a storm surge might overwhelm the hospital infrastructure. 3. The administrator is worried about the hospitals ability to respond to a large influx of clients from a disaster. 4. The administrator is concerned that a disaster would bring about the influx of media and frightened family.

Correct Answer: 3 Rationale 1: In this context, surge capacity is not about electrical power. Rationale 2: In this context, surge capacity is not about flood waters. Rationale 3: Surge capacity, when discussed in disaster planning, describes the facilitys ability to mobilize when suddenly confronted with a vast increase in client demand. Rationale 4: In this context, surge capacity is not only about media and family.

Question 21 Type: MCSA A nurse manager is trying to educate the staff regarding efficiency and how it affects the unit's costs. Strategies to increase efficiency could include which of the following? 1. Increasing the number of unlicensed assistants providing direct nursing care 2. Limiting dressing supplies on the nursing unit 3. Labeling the cost of each item in the clean supply closet 4. Eliminating staff education sessions

Correct Answer: 3 Rationale 1: Increasing the number of staff will not affect efficiency. Rationale 2: Limiting the amount of supplies will decrease efficiency because of the time factor involved in obtaining needed supplies. Rationale 3: When the cost of each item is displayed, staff becomes more aware of costs and may use supplies more wisely. Rationale 4: Eliminating staff education will not increase efficiency and may ultimately decrease efficiency.

Question 6 Type: MCSA A human resources (HR) manager knows which method of recruitment is most likely to be productive and inexpensive? 1. Internet websites 2. Advertisements in professional journals 3. Employee referrals 4. Job fairs

Correct Answer: 3 Rationale 1: Internet posting can be expensive and is not as effective as another option. Rationale 2: Advertising in professional journals can be expensive and is often not as effective as another option. Rationale 3: Nurses coming from informal referrals are likely to have more realistic information about the job and the organization; thus, their expectations most closely fit reality. Rationale 4: Job fairs can be effective if properly advertised but are usually not as effective as another option.

A manager is following up on an employee's injuries. The manager has contacted human resources to initiate the process of workers compensation. Which action would be appropriate by the manager? 1. Contact the employee's physician and inform him or her of the injuries. 2. Follow up with human resources regarding scheduling staff to cover the employee's absences. 3. Follow up with the employee to express concern and answer any questions regarding the situation. 4. Follow up with the workers compensation nurse.

Correct Answer: 3 Rationale 1: It is not appropriate for the manager to contact the employee's physician. Rationale 2: Human resources is not responsible for covering staff absences. Rationale 3: The manager should contact the injured employee to express concern for their well-being and follow up with any questions they may have. Rationale 4: The manager should not contact the workers compensation nurse.

Question 23 Type: MCSA The director of two nursing units is off on medical leave. The morale on these units has decreased over the past year. During the directors absence the chief nurse officer (CNO) notices a marked increase in the staffs morale. This causes the CNO to be concerned about which factor on these two units? 1. Lack of appropriate staffing when the manager is present 2. Recognition of the nurses performance may be lacking 3. A lack of authentic leadership 4. The manager may have unrealistic attitudes about staff work levels.

Correct Answer: 3 Rationale 1: Lack of appropriate staffing is not the overriding concern. Rationale 2: While this may be a part of the problem, it is not the major concern. Rationale 3: Authentic leadership is required for a healthy work environment. Since the morale on these units has increased in the directors absence, the CNO would be concerned about the managers leadership style. Rationale 4: This is not the primary concern.

A night shift charge nurse frequently points out nurse's faults in front of coworkers. The manager of the unit has submitted a written warning to the charge nurse. What term should the manager use to label this behavior? 1. Lateral violence 2. Unprofessionalism 3. Lack of civility 4. Bullying

Correct Answer: 3 Rationale 1: Lateral violence is harassment between employees of equal rank. Rationale 2: The behavior is unprofessional, but that is a very broad term and does not identify the issue in this particular case. Rationale 3: Lack of civility is defined as disrespectful or rude behavior. Rationale 4: Bullying is a broad term used to describe many behaviors. It is not specific to this situation.

Question 27 Type: MCSA A hospital administrator on a disaster planning team says, I am worried about our liability in using volunteers to provide care during a disaster. What should this team consider? 1. In disaster situations, no liability exists. 2. The hospital would have liability for what a volunteer does, but not for anything that happens to the volunteer. 3. The hospital could have liability for the volunteers performance and for his or her safety. 4. Hospital liability would be limited to any injuries sustained by the volunteer.

Correct Answer: 3 Rationale 1: Liability always exists and it may be heightened during a disaster. Rationale 2: Liability for both the volunteers safety and actions may exist. Rationale 3: Hospital liability could extend to actions taken by the volunteer and for anything that happens to the volunteer. Rationale 4: The hospital could be liable for injury to the volunteer or injury caused by the volunteer.

Question 16 Type: MCSA The chief nursing officer notes that the nursing department has exceeded budget in salary expenses for the last 3 months and asks the hospital nurse managers why this occurred. Which would be a cause for increased salaries? 1. Low client acuity for the past year 2. The increase in the amount of tuition reimbursement 3. A high turnover rate in nursing staff 4. The cost-of-living raise given

Correct Answer: 3 Rationale 1: Low client acuity does not cause salary cost to increase. Rationale 2: Tuition reimbursement is a benefit, not salary. Rationale 3: High turnover rate would increase salaries because of overtime wages to cover when nurses leave and additional staff hours for orienting newly hired nurses, as well as the cost of agency nurses. Rationale 4: A cost-of-living raise would have been figured into the budget. Global Rationale:

Question 28 Type: MCSA A hospital successfully implemented its disaster plan to manage providing care during a massive 3-day snow storm. What is the most likely way additional costs for this service will be paid? 1. Medicare will increase reimbursement for any client age 65 or over who was hospitalized during the disaster. 2. The federal government will pay any costs over and above the normal operating expenses for the time period. 3. The hospital will absorb the additional costs. 4. State and county governments have reserve funds to reimburse for such expenses.

Correct Answer: 3 Rationale 1: Medicare will not increase reimbursement. Rationale 2: There may or may not be federal reimbursement. If reimbursement is made it will likely not be at the full cost to the hospital. Rationale 3: It is likely that the hospital will absorb the additional costs. Rationale 4: There are likely no additional funds earmarked to reimburse the hospital for these expenses

Question 19 Type: MCSA A nurse is discussing the intent of the nurses collective bargaining representation to strike. The nurses spouse is concerned about the length of time the nurse may lose as a result of a strike. Which statement by the nurse is correct? 1. Nurses cant strike; its just a term on paper. 2. The hospital isnt allowed to replace my position because of a strike. 3. The hospital has a 10-day notice before we go on strike. 4. Not all staff nurses are included in the strike.

Correct Answer: 3 Rationale 1: Nurses do strike. Rationale 2: The hospital has the right and obligation to provide continuity of care. Rationale 3: By law, a 10-day notice must be given to allow hospitals the opportunity to prepare for striking nurses absences. Rationale 4: All staff nurses employed by the facility are included in the strike.

Question 13 A new nurse manager has conducted a series of interviews, but did not use an interview guide. Why would the managers director be dismayed that no interview guide was used? 1. Each organization has standardized interview questions that must be used. 2. The director has selected questions to ask the interviewee. 3. A list of standardized questions allows for reliability in comparing candidates. 4. The director was not included in the interview process.

Correct Answer: 3 Rationale 1: Organizations vary as to how interviews are conducted. Some organizations may have standardized questions for each candidate and some may have specific questions for each position. Rationale 2: Organizations vary as to how interviews are conducted. Some organizations may have standardized questions for each candidate and some may have specific questions for each position. Rationale 3: The use of structured or standardized interview questions allows for objectivity and consistency when interviewing candidates. This allows the manager to compare the candidates in a consistent manner. Rationale 4: There is no indication that the director wanted to be included in the interview process.

Question 13 Type: MCSA A new nurse manager has conducted a series of interviews, but did not use an interview guide. Why would the managers director be dismayed that no interview guide was used? 1. Each organization has standardized interview questions that must be used. 2. The director has selected questions to ask the interviewee. 3. A list of standardized questions allows for reliability in comparing candidates. 4. The director was not included in the interview process.

Correct Answer: 3 Rationale 1: Organizations vary as to how interviews are conducted. Some organizations may have standardized questions for each candidate and some may have specific questions for each position. Rationale 2: Organizations vary as to how interviews are conducted. Some organizations may have standardized questions for each candidate and some may have specific questions for each position. Rationale 3: The use of structured or standardized interview questions allows for objectivity and consistency when interviewing candidates. This allows the manager to compare the candidates in a consistent manner. Rationale 4: There is no indication that the director wanted to be included in the interview process.

Question 20 A chief nurse officer (CNO) is considering a collaborative effort with a school of nursing to offer externships to students. The chief financial officer (CFO) rejects the proposal because it will entail a cost to the organization. Which statement by the CNO would influence the CFO to reconsider this proposal? 1. Nursing is the foundation of this hospital and we have to get nurses into the organization. 2. We could hire students as nurse's aides, which would save costs. 3. An externship will allow the nursing students to work with nurses, learn about the organization, and create a positive impression of our facility. 4. Offering a nurse externship would allow the organization to create the types of nurses we would like to hire.

Correct Answer: 3 Rationale 1: Stating that nursing is the foundation of the hospital may alienate a CFO who works closely with staff from other departments. Rationale 2: Hiring nursing students as nurse's aides would save cost but this position may not allow for the student to experience a registered nurse's role. Rationale 3: The best rationale for an externship program is that it allows the students to work with nurses and to learn about the profession and how it is practiced in the organization. Hopefully, this will result in the student having a positive impression of the facility. Rationale 4: Create the types of nurses we would like to hire is a demeaning statement and would not be likely to influence a CFO positively.

Question 20 Type: MCSA A chief nurse officer (CNO) is considering a collaborative effort with a school of nursing to offer externships to students. The chief financial officer (CFO) rejects the proposal because it will entail a cost to the organization. Which statement by the CNO would influence the CFO to reconsider this proposal? 1. Nursing is the foundation of this hospital and we have to get nurses into the organization. 2. We could hire students as nurses aides, which would save costs. 3. An externship will allow the nursing students to work with nurses, learn about the organization, and create a positive impression of our facility. 4. Offering a nurse externship would allow the organization to create the types of nurses we would like to hire.

Correct Answer: 3 Rationale 1: Stating that nursing is the foundation of the hospital may alienate a CFO who works closely with staff from other departments. Rationale 2: Hiring nursing students as nurses aides would save cost but this position may not allow for the student to experience a registered nurses role. Rationale 3: The best rationale for an externship program is that it allows the students to work with nurses and to learn about the profession and how it is practiced in the organization. Hopefully, this will result in the student having a positive impression of the facility. Rationale 4: Create the types of nurses we would like to hire is a demeaning statement and would not be likely to influence a CFO positively.

A manager has conducted a nurses evaluation, focusing a large portion of the appraisal on the nurses personality. The nurse does not agree with the appraisal and contacts the human resources director. What is the soundest basis on which to dispute the appraisal? 1. The appraisal is incomplete. 2. The appraisal is unfair. 3. The appraisal is not valid. 4. The nurses perception of the appraisal is unjustified.

Correct Answer: 3 Rationale 1: The appraisal is technically not incomplete, but it is insufficient. Rationale 2: There is not enough information to judge the fairness of the appraisal. Rationale 3: Because the majority of the appraisal focused on the nurses personality, the appraisal is not valid. The focus of the appraisal should be how the nurses actions affect the work of the unit. Rationale 4: There is not enough information to judge whether the nurses perception of the appraisal is justified.

Question 15 Type: MCSA Which employee is eligible for leave under the Family and Medical Leave Act (FMLA)? 1. A female employee who has worked at the community hospital full time for 5 months and requests 12 weeks of maternity leave 2. A male employee who has worked two 12-hour shifts for a rural hospital on weekends for 12 months and requests a 12-week leave to care for a newly adopted child 3. A female employee who has worked for a large metropolitan hospital full time for 1 year and requests 3 months leave to care for her dying mother 4. A male employee who has worked full time at a small private clinic with 20 employees for the last 8 years and requests 12 weeks of leave to care for a new foster child

Correct Answer: 3 Rationale 1: The employee must have worked for the employer for at least 12 months. Rationale 2: The employee must have worked at least 1,250 hours in the last 12 months. Rationale 3: This employee has worked 12 months, at least 1,250 hours, and the hospital is large and therefore likely employs over 50 people. Rationale 4: The employee must be at a work site with 50 or more employees, or at a site where 50 workers are employed within 75 miles of the work site. A small private clinic with 20 employees does not meet this requirement.

Question 25 Type: MCSA A nursing unit is extremely short staffed. The manager calls a nurse who is on Family and Medical leave (FMLA) to ask the nurse to return to work 2 days prior to schedule. When the nurse declines, the manager becomes insistent. What should be the nurses first action? 1. Contact a lawyer. 2. Agree to return 2 days early. 3. Contact the human resources director. 4. Contact nursing administration.

Correct Answer: 3 Rationale 1: The employee should contact a lawyer only after all attempts to rectify the situation with the organization have been exhausted. Rationale 2: The nurse is assured the time off through FMLA and should not return to work early. Rationale 3: The nurses first action should be to contact the human resources (HR) director. Rationale 4: If the nurse contacts nursing administration, he or she is likely to be referred to the human resources department.

Question 28 Type: MCSA The nurse executive is addressing a conference on collective bargaining and nurses. Which statement should the executive include in this address? 1. It is clear that collective bargaining is the way of the future for nursing. 2. Collective bargaining does not help nurses influence the practice environment. 3. Your concerns that collective bargaining may separate staff nurses and managerial nurses are well founded. 4. The future of collective bargaining in nursing will begin to stabilize along with the health care environment.

Correct Answer: 3 Rationale 1: The future of collective bargaining in nursing is uncertain and unknown. Rationale 2: The primary reason nurses participate in collective bargaining is to influence the practice environment. Rationale 3: One of the major concerns regarding collective bargaining in nursing is the fear that this separation will occur. Rationale 4: There is no indication that this is going to occur in the near future.

A nurse manager has been working with a disgruntled employee for several weeks. Today the employee comes to the manager's office with yet another complaint about a new hospital policy. The manager says, I am sick of your complaining. Leave me alone so I can get some work done. What should the manager do now? 1. Firmly shut the office door. 2. Tell the employee to go to human resources with complaints about the policy change. 3. Apologize to the employee for being unprofessional and ask what the issue with the policy is. 4. Tell the employee to go back to work.

Correct Answer: 3 Rationale 1: The manager has made a tactical error and should not just shut the door. Rationale 2: There is no reason to send the employee to HR. Rationale 3: The manager must remain professional at all times. In this case, when the manager was not professional, an apology is in order. Rationale 4: The manager has made a tactical error and should not send this employee back to work.

Question 30 Type: MCSA During an interview, the manager has a strong impression that the applicant is a good fit for the position. How should the manager proceed? 1. Offer the applicant the job. 2. Cancel the remaining interviews for the position. 3. Keep this feeling in mind but do not make a hasty decision. 4. Tell the applicant that he or she is the strongest candidate for the position.

Correct Answer: 3 Rationale 1: The manager should not offer the job until all preemployment checks have been done by human resources. Rationale 2: The manager should continue interviewing the rest of the applicants. Rationale 3: Mistakes are often made based upon first impressions. Rationale 4: The manager should not tell the applicant that he or she is the strongest candidate. This is confidential information until the job offer is made.

During appraisal interviews, the nurse manager defends the choice of rating by emphasizing the negative aspects of the nurses performance. What is the likely outcome of this strategy? 1. The nurse will clearly see the impact of attitude on performance. 2. The nurse will identify ways that performance can be improved. 3. The nurse will pay less attention to maintaining what is done well. 4. The nurse will ignore the negative statements and focus only on the positive.

Correct Answer: 3 Rationale 1: The nurse will not see the relationship between attitude and performance just because negative statements were made. Rationale 2: The nurse is less likely to identify ways that performance can be improved if making only negative statements. Rationale 3: Focusing only on the negative aspects of a nurses performance can result in the nurse discounting the importance of the things the nurse does well. If this is the case, the nurse may pay less attention to those areas in the future and may not do them as well. Rationale 4: The nurse is unlikely to simply ignore the negative statements and will probably not focus on ways to improve as well as if positive statements had also been made.

Question 16 Type: MCSA The chief nurse officer (CNO) receives a call that the candidate for a nurse opening has arrived, but that the unit manager who was to have interviewed the candidate had to work an unscheduled night shift and is unavailable. Which action by the CNO is appropriate? 1. Inform the candidate the interview will have to be rescheduled. 2. Have the HR department refer the candidate to a nurse on the unit. 3. The CNO should conduct an initial interview and arrange for a second interview with the manager. 4. The CNO should call the manager and conduct an interview via a conference call.

Correct Answer: 3 Rationale 1: The purpose of the interview is to gain information about and supply information to the candidate. Rescheduling will not promote a positive impression of the facility. Rationale 2: The interview should be conducted by someone prepared to interview. A nurse on the unit will be busy with clients and does not have time to prepare for or conduct the interview. Rationale 3: Interviewing the candidate and informing the candidate of the intention of a second interview with the manager is a professional approach for managing this situation. Rationale 4: The manager is likely not prepared to conduct this interview via a conference call and may be sleeping.

Question 5 Type: MCSA A housekeeping employee is questioning the employees agent regarding the role of administering the ratified contract. The agent should explain to the employee that this role belongs to which person? 1. Union president 2. Hospital administrator 3. Designated union representative 4. Bargaining agent

Correct Answer: 3 Rationale 1: The union president is most active during the collective bargaining phase or when negotiating the contract and does not administer the contract. Rationale 2: The hospital administrator is responsible for adhering to the negotiated contract but does not administer it. Rationale 3: A designated hospital staff nurse may serve as the union representative. It is the duty of this nurse to provide fair and equal representation to all members of the unit. Rationale 4: The bargaining agent is most active during the collective bargaining phase or when negotiating the contract but does not administer the contract.

An assistant nurse manager has relieved a staff nurse for lunch. After the nurse leaves, the assistant manager realizes there is a nursing administration meeting at noon. Which stress-producing event does this exemplify? 1. Poor leadership 2. Mismanagement of the unit 3. Role conflict 4. Miscommunication

Correct Answer: 3 Rationale 1: The unit was managed effectively so staff could get to lunch, which reflects good management and leadership skills. Rationale 2: The unit was managed effectively so staff could get to lunch, which reflects good management and leadership skills. Rationale 3: Role conflict occurs when an individual has two competing roles. The assistant manager was caught between the role of being a helper to staff and attending the meeting. Rationale 4: There was no miscommunication.

Question 17 Type: MCSA A nurse assistant states, I dont understand why they would select a nurse to be the union representative. Which response by a coworker is appropriate? 1. Administration chose a nurse for this role. 2. Why do you care who is the representative? 3. The representative must be an employee of the union or a member of the nursing staff. 4. The representative must be a nurse if the unionized organization is a hospital or health care organization.

Correct Answer: 3 Rationale 1: This person is not chosen by administration. Rationale 2: It is important that all staff know who the representative is. Rationale 3: The union representative may be an employee of the union or a member of the nursing staff. Rationale 4: The union representative may be an employee of the union or a member of the nursing staff.

A hospital administrator is investigating why the turnover rate is so high and why it is difficult to attract new nursing employees. Which situation is most likely to have resulted in this problem? 1. The hospital is in a poorer part of town and offers a great deal of charity care. 2. The hospital pays about $.25 per hour less than other hospitals as a starting wage for nurses. 3. The hospital has a reputation for allowing bullying behavior to occur. 4. The other hospital in town has a more modern building and campus.

Correct Answer: 3 Rationale 1: While some staff may be put-off by the area of town and the fact that charity care is provided, this is not the most probably reason for the situation. Rationale 2: Twenty-five cents is not enough of a difference in wages to explain this situation. Rationale 3: People do not like to be bullied. If the hospital has this reputation it is unlikely to attract new employees and older employees are likely to leave. Rationale 4: Physical facilities are important, but are not likely important enough to be the most probable cause of this situation.

As part of a new time management initiative, the nurse manager is creating a to-do list. How should the manger structure this list? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Focus on the events that are planned for each day. 2. Focus on the activities the manager expects for the day. 3. Block out time for the unexpected. 4. Be certain the list is flexible. 5. Do not create a to-do list for more than one day at a time.

Correct Answer: 3,4 Rationale 1: The focus should be on outcomes, not events. Rationale 2: The focus should be on outcomes, not activities. Rationale 3: The manager should leave enough uncommitted time to allow for unexpected occurrences to be handled. Rationale 4: Flexibility is of paramount importance in health care. Rationale 5: In some work environments, to-do lists may be better focused on what needs to be done each week. Adding a system to keep track of weekly or monthly standing meetings or appointments is also helpful.

The nurse manager must attend to several tasks this afternoon. Which tasks would the manager categorize as urgent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Waiting for pharmacy to call back about a meeting time 2. Planning a staff meeting for next week 3. Assisting a family whose child is in the emergency department 4. Finding replacements for two staff members on the next shift who called in sick 5. Trying to organize the visitor take-out menus

Correct Answer: 3,4 Rationale 1: Waiting for a phone call is a time waster and would not be an urgent task. Rationale 2: Planning a staff meeting for next week in not urgent. Rationale 3: Assisting the family of a child in the ED is an urgent matter. Rationale 4: Finding replacement staff for the next shift is an urgent matter. Rationale 5: Organizing take-out menus is busy work.

Question 11 Type: MCMA The nurse manager is reviewing the previous months budget and notes a favorable efficiency variance of the full-time equivalents (FTEs). Which options may be reasons for this favorable variance? Standard Text: Select all that apply. 1. Greater client acuity 2. Extravagant use of resources 3. Understaffing the unit 4. Low client acuity 5. Use of agency nurses to supplement staff

Correct Answer: 3,4 Rationale 1: Greater client acuity than allowed for in the budget would likely result in an unfavorable efficiency variance. Rationale 2: Using more resources than the budget allows would result in an unfavorable efficiency variance. Rationale 3: Understaffing the unit would mean fewer nursing salary hours. This would result in a favorable efficiency variance, but would not be a good long-term plan for quality of care. Rationale 4: If client acuity is lower, fewer staff members are needed. This would result in a favorable efficiency variance. Rationale 5: If agency nurses were used to supplement staff, the efficiency variance would be unfavorable.

Question 10 The nurse manager is conducting an interview for a position as a full-time RN in a critical care unit. Which statements by the nurse manager would be most effective in selecting a qualified nurse for this position? Standard Text: Select all that apply. 1. I have 20 years of experience as a critical care nurse and I am an advanced practice nurse in adult medical-surgical nursing. 2. We do lots of client teaching. Do you like doing client teaching? 3. Tell me about your past work experience. 4. Please tell me about your most rewarding experience as a nurse. 5. Have you ever cared for a client on a ventilator?

Correct Answer: 3,4 Rationale 1: Questions should be focused on the candidate, not the person conducting the interview. Rationale 2: This is a leading question, which should be avoided. The obvious correct answer is yes. Rationale 3: Information about past work experience is helpful in determining qualifications for the prospective job. Rationale 4: Asking about the most rewarding experience as a nurse may reveal much about the nurse's past. Rationale 5: Whether or not a candidate has cared for a client on a ventilator does not prove the applicant's ability.

Question 10 Type: MCMA The nurse manager is conducting an interview for a position as a full-time RN in a critical care unit. Which statements by the nurse manager would be most effective in selecting a qualified nurse for this position? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I have 20 years of experience as a critical care nurse and I am an advanced practice nurse in adult medicalsurgical nursing. 2. We do lots of client teaching. Do you like doing client teaching? 3. Tell me about your past work experience. 4. Please tell me about your most rewarding experience as a nurse. 5. Have you ever cared for a client on a ventilator?

Correct Answer: 3,4 Rationale 1: Questions should be focused on the candidate, not the person conducting the interview. Rationale 2: This is a leading question, which should be avoided. The obvious correct answer is yes. Rationale 3: Information about past work experience is helpful in determining qualifications for the prospective job. Rationale 4: Asking about the most rewarding experience as a nurse may reveal much about the nurses past. Rationale 5: Whether or not a candidate has cared for a client on a ventilator does not prove the applicants ability.

Question 27 Type: MCMA Which statements by a nurse manager would the supervisor interpret as indicating an understanding of why collective bargaining is complicated for nurses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. There just are not many union options for nurses. 2. None of the unions available for nurses were developed specifically for nurses. 3. The determination of who is eligible to join a union is complicated. 4. In some institutions, nurses have formed their own unions. 5. No nursing unions have the backing of national organizations like the AFL/CIO.

Correct Answer: 3,4 Rationale 1: Several organizations offer union options for nurses. Rationale 2: National Nurses United and United American Nurses are organizations specifically for nurses. Rationale 3: The determination of who is a supervisor is complicated in nursing. Rationale 4: Nurses in some institutions have formed their own unions. Rationale 5: Untied American Nurses is an AFL/CIO affiliate.

Question 9 Type: MCMA A hospital is experiencing a high nursing turnover rate. One manager suggests offering sign-on bonuses to fill positions. Why would the nurse executive veto this suggestion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Sign-on bonuses only attract newly licensed nurses. 2. The bonus schedule adversely impacts the current salary schedule. 3. Current nurses can be discouraged by this program. 4. Sign-on bonuses do not recognize achievement and loyalty. 5. Sign-on bonuses do not attract enough nurses to make it worth the time to set them up and advertise them.

Correct Answer: 3,4 Rationale 1: Sign-on bonuses are attractive to many nurses, both newly licensed and experienced. Rationale 2: Sign-on bonuses do not affect the current salary schedule. Rationale 3: Nurses currently working at the facility can be discouraged when newly hired nurses are given big amounts of money just for taking the job. Rationale 4: Sign-on bonuses are awarded just for taking the job. They do not recognize such attributes as experience, achievement, and loyalty. Rationale 5: Sign-on bonuses can attract a significant number of applicants and are a quick fix for shortages.

A nurse has complained to the human resources (HR) director regarding unfair treatment by the nurses manager. The nurse describes receiving a written warning, unlike other nursing staff who exhibit similar behaviors but are not reprimanded. Which concerns would the HR director discuss with the hospital chief nursing officer? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The unusual management styles within the department 2. Confronting the managers direct supervisor about allowing this situation to occur 3. The apparent inconsistencies in discipline within the unit 4. The potential for litigation that arises from this complaint 5. The need to terminate this problem employee

Correct Answer: 3,4 Rationale 1: This is not just an unusual management style. Rationale 2: The managers direct supervisor may be unaware that the incident happened. The supervisor should be apprised of the complaint, but not confronted with an accusation of allowing the behavior. Rationale 3: There is apparently an inconsistency in discipline that should be investigated. Rationale 4: If this situation goes to court, the hospital could be found liable for the actions of the manager. Rationale 5: The HR director should not categorize this employee as a problem until a full investigation of the situation has been conducted.

Question 28 Type: MCMA The nurse manager charged with hiring staff for a new nursing unit explains the units rigid structure and scheduling policies to all potential applicants. The manager is most likely to lose the interest of applicants of which generations? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Traditionals 2. Baby boomers 3. Generation X 4. Generation Y 5. Nurses in general do not like structure and rigidity in scheduling.

Correct Answer: 3,4 Rationale 1: Traditionals in general like structure and are more likely to work well with inflexible schedules. Rationale 2: Baby boomers in general do fairly well with structure and rigid scheduling. Rationale 3: Generations X in general does not like structure and is interested in flexible scheduling. Rationale 4: Generation Y in general does not like structure and is interested in flexible scheduling. Rationale 5: Some nurses thrive in an environment with lots of structure and a predictable, somewhat rigid schedule.

A nurse has two job offers. One will not be available for 6 months and the other is in an organization that the nurse does not think is a good fit. The client care in the second organization is not what the nurse would feel comfortable providing. What action should the nurse take in regard to the second organization? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Gracefully decline the job by saying he is moving out of state. 2. Accept the position and plan to resign as soon as the other position opens. 3. Thank the manager for the offer, but decline it. 4. Send a letter to the manager, thanking the organization for the offer. 5. Tell the manager that the client care in the organization was not what was expected.

Correct Answer: 3,4,5

Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I would like to change the format we use for shift report, but Im afraid it would upset staff members who have been here a long time. 2. This is the decision I have made, and there is no room for discussion. 3. I would like to thank everyone for your hard work and dedication while we have been short staffed. 4. I am certain that our new assignment system is going to make the workload more equitable. 5. I know this week has been rough. I feel a little like sandpaper myself.

Correct Answer: 3,4,5 Rationale 1: Basing decisions on placating staff indicates the leader is insecure and does not energize staff or promote creativity. Rationale 2: The leader who does not value input from staff will not promote creativity. Rationale 3: The leader who recognizes the staffs efforts and sacrifices is more likely to energize the staff. Rationale 4: Optimism is crucial to energizing staff and promoting creativity. Rationale 5: Humor is a good method to help energize staff and promote creativity.

A staff nurse frequently interrupts the nurse manager with problems that the staff nurse could solve. What should the manager say to correct this behavior? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I am no longer going to interrupt my work for you. 2. Let me see what I can do about the problem you are having. 3. Is this a problem you can handle yourself? 4. You have the skills to solve this issue. 5. I trust you to solve this problem.

Correct Answer: 3,4,5 Rationale 1: The manager should be available for solving problems outside the staff nurses scope of accountability. Telling the nurse that interruptions will not be tolerated may result in the nurse not notifying the supervisor of a situation that requires the managers expertise. Rationale 2: The manager should not take responsibility for solving the problem. It is the nurses responsibility. Rationale 3: Refocusing the nurses ability to handle the problem may make the nurse reassess the need for the managers intervention. Rationale 4: Reminding the nurse that he or she has the skills to solve the issue may give the nurse enough courage to attempt independent problem solving. Rationale 5: A statement of trust in the nurses judgment may give the nurse enough courage to attempt independent problem solving.

The nurse has made several near errors in client care in the last 2 months. The nurse manager says, These are simple errors. You just arent listening. How could the nurse improve listening skills in this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse should try to think ahead about what the person talking is going to say. 2. The nurse should hold eye contact with the speaker at all times. 3. When listening to instructions, the nurse should ask anyone who interrupts to wait a moment. 4. The nurse should get sufficient time away from work to rest. 5. The nurse should be careful not to prejudge what the speaker is going to say.

Correct Answer: 3,4,5 Rationale 1: Thinking ahead in conversation interferes with the ability to listen and comprehend. Rationale 2: Eye contact does not mean the nurse is listening. Rationale 3: When many people are talking at one time, it is difficult to listen and comprehend. Rationale 4: Being tired and stressed from too much time at work can cause energy to flag, resulting in difficulty listening. Rationale 5: Preconceived beliefs about what the speaker is going to say makes it more likely that the nurse is not going to listen effectively.

Question 26 Type: MCMA Which personal characteristics would increase a nurses potential for voluntary turnover? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The nurse holds an associates degree in nursing. 2. The nurse walks to work each day. 3. Through task force meetings, the nurse has become friends with several nurses who work in different organizations in town. 4. The nurse has few personal ties to the city of current employment. 5. The nurse has worked at several job-fairs in the area as a hospital representative.

Correct Answer: 3,4,5 Rationale 1: A nurse who holds a higher degree is likely to be more mobile. Rationale 2: If the nurse lives within walking distance to the hospital he or she is less likely to voluntarily resign. Rationale 3: Having contacts in other health care organizations increases the nurses likelihood of changing work sites. Rationale 4: If the nurse is geographically mobile, leaving for a change of scenery is attractive. Rationale 5: Attending job fairs, even as a hospital representative, opens up new contacts and possibilities of new jobs.

Which factors increase the stress associated with interpersonal relationships in health care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Longer length of stay for clients 2. Few assistive personnel 3. Job redesign 4. New technology 5. Unrealistic expectations of other disciplines

Correct Answer: 3,4,5 Rationale 1: A shorter length of stay for clients is more likely to increase staff stress. Rationale 2: Having to supervise assistive personnel is very stressful. Rationale 3: Trying to do more with less is very stressful. Rationale 4: New technology can be very stressful during the learning curve. Rationale 5: Unrealistic expectations from anyone can increase the nurses stress.

Question 6 A nurse says, I don't see what all the fuss is about bullying. Every new nurse has to go through it. It is just a part of the history of nursing. How should the manager respond? Standard Text: Select all that apply. 1. I know. It's a shame that all the old ways are changing. 2. Why would you want to bully a new nurse? They are all so naive and cute. 3. The Joint Commission does not tolerate disruptive or abusive behavior. 4. The American Nurses Association does not approve of bullying behaviors. 5. New nurses bring new ideas. Why would you bully them?

Correct Answer: 3,4,5 Rationale 1: Agreeing with the nurse only serves to reinforce the behavior. Rationale 2: A statement about the new nurse being nave and cute is a bullying behavior. Rationale 3: The Joint Commission recommends a zero-tolerance policy regarding disruptive or abusive behavior. Rationale 4: The ANA recommends several strategies to combat these behaviors. Rationale 5: New ideas are brought by new nurses. Bullying of any segment of the profession is wrong.

Question 7 A nurse makes a medication error and notifies the clients physician. The physician berates the nurse over the phone and states, you are an idiot. How should the manager deal with this situation? Standard Text: Select all that apply. 1. Tell the nurse to go home for the rest of the day. 2. Have the nurse call the physician back and demand an apology. 3. Document the facts of the encounter. 4. Privately tell the physician that the behavior was bullying. 5. Confront the physician during rounds and demand an explanation.

Correct Answer: 3,4,5 Rationale 1: There is no reason for the nurse to go home. Rationale 2: The manager should not anger both parties more by creating another immediate encounter. Rationale 3: The facts of the encounter must be documented. Rationale 4: The manager should name the behavior. Rationale 5: The manager should speak to the physician in a civil manner.

A nurse manager has identified that a major time waster is the amount of time spent on the telephone each day. Which strategy would help reduce this time? 1. Answer the phone, Hello, how are you? 2. Send all calls to voice mail. 3. Use e-mail for potentially troublesome issues. 4. Set a specific block of time to return calls.

Correct Answer: 4 Rationale 1: Answering the phone this way encourages socializing and small talk. Rationale 2: There are situations in which issues must be dealt with immediately and face-to-face. Rationale 3: Troublesome issues should be addressed face-to-face. Rationale 4: The nurse manager should set time aside to handle routine phone calls and to return calls.

The nurse is always intimidated when asking a physician to clarify orders. Which statements should the nurse use to help counteract this feeling? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Im sorry, Doctor, but I need for you to repeat the dosage on that medication order. 2. Doctor, what was the dosage on that medication you just ordered, and do you want the client to get up in the chair today? 3. How often did you want the furosemide given? 4. Uh, can you tell me if you need for this client to be NPO today? 5. Doctor, what rate did you want for the IV?

Correct Answer: 3,5 Rationale 1: Saying Im sorry discounts the message. Rationale 2: The nurse should focus on one point at a time. Rationale 3: This is a direct statement. Rationale 4: This statement is weak. Avoid uh and um. Rationale 5: This is a direct statement, and it starts with a name that gets the physicians attention.

Question 18 Type: MCMA As part of the disaster plan, the nurse executive is planning an education session on the core competencies for nurses established by the National Emergency Preparedness Education Coalition. Which topics should be included in the handout being written for this session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Cost control 2. Managing conflict with other disciplines 3. Communication 4. Handling the media 5. Technical skills

Correct Answer: 3,5 Rationale 1: Cost control is not one of the core competencies for nurses established by this group. Rationale 2: Conflict management is not one of the core competencies for nurses established by this group. Rationale 3: Communication is a core competency for nurses established by this group. Rationale 4: Handling the media is not one of the core competencies for nurses established by this group. Rationale 5: Technical skills are a core competency for nurses established by this group.

Question 26 A nursing applicant is scheduled for an interview with the nurse manager. Prior to the day of the interview, the human resources (HR) department reports that the applicant's references would not recommend her for hire. How should the nurse manager proceed? Standard Text: Select all that apply. 1. Have HR call the applicant and cancel the interview. 2. Call the applicant, tell her that the references were poor, and cancel the interview. 3. Conduct the interview without telling the applicant that the references were poor. 4. Conduct the interview and tell the applicant that the references were poor. 5. Conduct the interview and see if the applicant spontaneously explains why the references might be poor.

Correct Answer: 3,5 Rationale 1: The interview should be conducted. Rationale 2: The manager should not reveal that the references were poor. The interview should be conducted. Rationale 3: The interview should be conducted. The fact that references were poor should not be revealed. Rationale 4: The applicant should not be told the references were poor. Rationale 5: The applicant may explain situations that could have resulted in poor references.

Question 26 Type: MCMA A nursing applicant is scheduled for an interview with the nurse manager. Prior to the day of the interview, the human resources (HR) department reports that the applicants references would not recommend her for hire. How should the nurse manager proceed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Have HR call the applicant and cancel the interview. 2. Call the applicant, tell her that the references were poor, and cancel the interview. 3. Conduct the interview without telling the applicant that the references were poor. 4. Conduct the interview and tell the applicant that the references were poor. 5. Conduct the interview and see if the applicant spontaneously explains why the references might be poor.

Correct Answer: 3,5 Rationale 1: The interview should be conducted. Rationale 2: The manager should not reveal that the references were poor. The interview should be conducted. Rationale 3: The interview should be conducted. The fact that references were poor should not be revealed. Rationale 4: The applicant should not be told the references were poor. Rationale 5: The applicant may explain situations that could have resulted in poor references.

A newly licensed nurse has submitted an application, letter of interest, and rsum to the human resources department of a hospital and has an interview scheduled for next week. How should the nurse prepare for this interview? 1. Write down and memorize answers to questions that are typically asked. 2. Go to the organization and try to talk to some staff nurses. 3. Add additional information to the rsum. 4. Review the organizations website.

Correct Answer: 4

A nursing supervisor is seeking staff input while developing policies regarding violence prevention. A staff nurse says, we have lots of threatening behaviors on our unit. What is the most important question for the supervisor to ask? 1. Why is so much threatening behavior happening on your unit? 2. Why haven't you reported that? 3. Where do you work? 4. When you report threats to your manager, is action taken quickly?

Correct Answer: 4

During an annual performance review, the staff nurse admits to being very stressed by the demands of the job, marriage, and four teenage children. Which comment by the nurse manager is indicated? 1. We need to figure out what you can give up in your personal life to help decrease your stress. 2. You need to be more flexible with the hours you work. 3. You should not let your personal problems affect your work. 4. Lets talk about how we can help you develop some resiliency.

Correct Answer: 4

Question 14 An OB manager is interviewing a registered nurse for a labor and delivery position. The manager asks the interviewee, Tell me about the most challenging delivery experience in your nursing career, and learns the candidate has experienced several challenges that required quick action. Which nursing skill will this exchange best assess? 1. Adaptability 2. Negotiation skills 3. Initiative 4. Decision-making skills

Correct Answer: 4

Question 28 A nurse is suspected of abusing narcotics. A thorough investigation has been performed, and the nurse will now be notified of the suspicion and investigation. How should this notification be handled? 1. A certified letter outlining the accusation and investigation should be sent to the nurse's home. 2. A certified letter outlining the accusation and investigation should be sent to the nurse at work. 3. The nurse should be contacted and asked to make an appointment with the nurse executive without giving cause. 4. The nurse should be approached at work with no prior notice and asked to come to the nurse executive's office.

Correct Answer: 4

Question 5 A new graduate nurse is preparing for an interview by the nurse recruiter. The applicant should be ready to be asked questions about which topic? 1. General state of health 2. Availability of transportation to work 3. Previous military service 4. Willingness to work all shifts

Correct Answer: 4

An inexperienced speaker is practicing the delivery of a speech. Which statement indicates a lack of understanding about how easily communication is distorted? 1. I know I can better connect with my audience with good eye contact. 2. If I repeat a complicated section in another way, comprehension is improved. 3. If I know the background of the audience, it can help with tailoring the content. 4. The topic is not complicated, so I dont have to worry about misunderstanding.

Correct Answer: 4 Rationale 1: Eye contact can assist in keeping the message clear. Rationale 2: Repeating the message can assist in keeping the message clear. Rationale 3: Tailoring the message can assist in keeping it clear. Rationale 4: It does not matter how uncomplicated the topic is; misunderstandings and distortions can still occur.

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a 2-week gap in the meetings to allow which portion of the creative process to occur? 1. Farsight 2. Verification 3. Preparation 4. Incubation

Correct Answer: 4 Rationale 1: Farsight is not part of this process. Rationale 2: Verification is evaluation of the solutions effectiveness. Rationale 3: Preparation is planning time. Rationale 4: The period of lapsed time before a decision is made is the incubation time.

A nurse managers week is filled with handling routine and repetitive issues. Which strategy should the manager employ to make handling these tasks most effective and efficient? 1. Ask those involved to leave voice mail messages about any routine matter. 2. Encourage those involved in routine matters to call between 10:00 a.m. and 12:00 p.m. each day. 3. Keep the office door open to be accessible to those dealing with these routine tasks. 4. Hold a meeting each week especially for dealing with routine and nonurgent matters.

Correct Answer: 4 Rationale 1: Having people leave voice mail messages is not efficient. The manager must then take time to retrieve, listen to, and respond to these messages. Voice mail also does not facilitate the face-to-face discussion often necessary to address routine issues. Rationale 2: Having a designated time for handling these issues is probably the second best option. However, spending 2 hours each day may be excessive. Also the hours between 10:00 a.m. and 12:00 p.m. are often extremely busy, both for the nurses handling routine issues and for the nurse manager. Rationale 3: Allowing unlimited access to the nurse manager encourages drop-in visits, which can be time wasters. Rationale 4: Having a regularly scheduled meeting encourages those with routine questions to hold their concerns for a specific time. Setting this time aside also allows time for thoughtful discussion of topics as necessary.

In which situation should the nurse be most concerned that communication was distorted? 1. The nurse obtains an admission history from the parents of an adopted child. 2. The nurse gives discharge instructions to a couple in their early 80s. 3. The nurse manager hires a new nurse originally from the Philippines. 4. The emergency nurse receives a client who was transferred via ambulance for confusion.

Correct Answer: 4 Rationale 1: Just because this child is adopted does not mean that the admission history will not be correct or that communication with the child or parents will be impaired. Rationale 2: Just because a person is older does not mean that communication is impaired. Rationale 3: Just because the person is from another country does not mean that communication will be distorted. Rationale 4: Communication will be most affected by the confusion of the client because the nurse cannot be sure of anything the client said or that the client understood anything the nurse tried to communicate.

Question 18 Type: MCSA The nurse manager is calculating the cost of offering two bonus incentives to nursing staff for covering call-ins for sickness. After reviewing the statistics, the manager finds that option A is more cost-effective than option B but decides to implement option B because it seems safer. Which option best describes the basis of this decision? 1. Probability 2. Probability analysis 3. Objective probability 4. Subjective probability

Correct Answer: 4 Rationale 1: Probability is the likelihood, expressed as a percentage, that an event will or will not occur. Rationale 2: Probability analysis is a method of calculating expected risk; this is the method the nurse used to compare the two options. Rationale 3: Objective probability is the likelihood that an event will or will not occur, based on facts and reliable information. Rationale 4: Even though option A is more cost-effective, the manager believes option B to be in the best interest of the unit. Subjective probability is the likelihood that an event will or will not occur based on personal judgment and beliefs.

The nurse manager is significantly behind in the required paperwork for the job. How can the manager rectify this situation? 1. Make stacks of work on the corner of the desk so the work can be seen. 2. Use paper for all communication so a record is kept. 3. Discontinue subscriptions to all journals. 4. Set a goal to work on paperwork for a portion of every day.

Correct Answer: 4 Rationale 1: Stacking work around the desk can make work more difficult and overwhelming. It is better to file materials and keep a running to-do list of projects. Rationale 2: Using e-mail for communication reduces the amount of paper flow through the office, thereby reducing clutter. Rationale 3: The nurse manager must keep current on nursing issues, so the journal subscriptions are important and should be maintained. Rationale 4: The best of these options is to set a goal to work on paperwork for a portion of every day.

The nurse manager is concerned about a family members complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue? 1. Post a memo to the nursing staff about expected professional behavior. 2. Send an e-mail to the nursing staff about expected professional behavior. 3. Address the complaint with the individual nurse in a telephone conversation. 4. Discuss the complaint with the individual nurse face-to-face.

Correct Answer: 4 Rationale 1: The purpose of a memo is to convey general information to a group; it has a low level of personal intimacy. Rationale 2: The purpose of e-mail is to broadcast information to large groups; it has a low level of personal intimacy. Rationale 3: A telephone conversation is less intimate than face-to-face communication, and the individuals response cannot be seen. Rationale 4: More important or difficult issues should be communicated face-to-face to the nurse involved so that the individuals response can be seen and questions can be answered appropriately.

A female nurse has an interview for a new job scheduled next week. What should the nurse plan to wear to this interview? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Scrubs 2. A neatly pressed lab jacket and white uniform 3. Capri length pants and sandals 4. Dark pants and a gray jacket 5. Simple jewelry

Correct Answer: 4,5

Question 16 Type: MCSA The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity? 1. Watch others implement creative solutions. 2. Work with a group to implement a creative solution. 3. Evaluate the effectiveness of creative solutions. 4. Practice the steps of the process as often as possible.

Correct Answer: 4 Rationale 1: Watching others implement creative solutions would be helpful in improving the nurses creativity, but it is not the best of these choices. Rationale 2: Working with a group to implement a creative solution would be helpful in improving the nurses creativity, but it is not the best of these choices. Rationale 3: Evaluating the effectiveness of creative solutions would be helpful in improving the nurses creativity, but it is not the best of these choices. Rationale 4: The most effective of these methods would be practicing the steps. Creativity is a skill that can be learned and improved through practice, just like technical skills.

The staff nurse would like to improve personal communication with peers, patients, and the medical staff. Which strategy would be most effective for this nurse? 1. Plan to be more assertive in all communication. 2. Work to manage fear of conflict. 3. First learn to delegate clearly to others. 4. Attend the hospital-based communication training.

Correct Answer: 4 Rationale 1: While being more assertive in communication could help this nurse, this is not the most complete option. Rationale 2: Working to manage fear of conflict is not the most complete option. Rationale 3: Learning to delegate clearly would help the nurse learn to communicate better, but this is not the most effective strategy. Rationale 4: Attending training on communication would be the best plan for this nurse. The strategies described in the other options would likely be included in this training.

For the last several weeks, the nurse manager has felt as if there is not enough time in the day to accomplish all the required tasks. The manager goes home exhausted and does not look forward to going to work in the morning. What strategy may help alleviate some of this stress? 1. Do tasks as quickly as possible. 2. Hurry through work, hoping someone else will catch any mistakes that are made. 3. Do not start any new tasks after lunch. 4. Pick a simple task and complete it just before going home each day.

Correct Answer: 4 Rationale 1: Working faster is not likely to reduce this managers stress. Rationale 2: Hurrying through work often results in mistakes. Hoping that someone else will catch the mistakes is not fair to others and can be dangerous. Rationale 3: The nature of nursing is unpredictable. The manager is unlikely to be able to stick to a plan of not starting any new projects after lunch. Rationale 4: Completing a task just before the end of the day helps the manager go home with a sense of accomplishment.

Question 18 An error made in client care last week has just been discovered. A nurse who cared for the client during that period is asked about the error and states, that probably happened when the nurse covering for me at noon or for my breaks was in charge. How should the manager interpret this statement? 1. This is a plausible explanation of who was in charge at the time of the error. 2. The coverage nurse is likely incompetent. 3. This nurse was not in charge when the error was made. 4. This nurse is scapegoating the coverage nurse.

Correct Answer: 4 Rationale 1: A statement this broad is likely not a clear explanation. Rationale 2: There is no indication that the coverage nurse is incompetent. Rationale 3: There is no evidence that this nurse was not in charge when the error was made. Rationale 4: By raising the possibility (and being very sure) that the other nurse was in charge, the nurse has created a scapegoat. This is a form of lateral violence.

Question 14 Type: MCSA An OB manager is interviewing a registered nurse for a labor and delivery position. The manager asks the interviewee, Tell me about the most challenging delivery experience in your nursing career, and learns the candidate has experienced several challenges that required quick action. Which nursing skill will this exchange best assess? 1. Adaptability 2. Negotiation skills 3. Initiative 4. Decision-making skills

Correct Answer: 4 Rationale 1: Adaptability focuses on how an experience has affected the nurse and how the nurse handled the situation. Rationale 2: Negotiation skills provide information as to how the nurse was able to compromise in a situation. Rationale 3: Initiative provides the interviewer with information as to the nurses resourcefulness. Rationale 4: Decision-making skills provide the interviewer with information about the nurses thought process in managing a difficult or challenging situation.

Question 4 Type: MCSA The nurses in an organization are in the process of selecting a bargaining agent. Which action by the nurse executive is considered a fair labor practice? 1. Promising wage increases if the desired agent is chosen 2. Questioning staff nurses regarding their vote 3. Threatening demotions if the desired agent is not chosen 4. Disallowing collective bargaining organizational meetings at the hospital

Correct Answer: 4 Rationale 1: Administrators are not allowed to promise incentives in return for a favorable selection. Rationale 2: Nursing management is not allowed to question nurses regarding their feelings about the union activity. Rationale 3: Nursing administrators are not allowed to threaten punishment for undesirable choices. Rationale 4: Nursing administrators are not required to allow union activities on hospital property or during working hours.

Question 1 Type: MCSA A nurse manager is working on a task force to develop policy for man-made disasters. There is some discussion in the committee about whether fire should be included in the policy. Which suggestion by a task force member would be most useful? 1. Fire is a natural occurrence, so we should not address it. 2. Fires are not generally a real disaster, so we should not include it. 3. We should only focus on wildfires. 4. We should only focus on arson fires.

Correct Answer: 4 Rationale 1: Fire is natural, but not all are from a natural source. Rationale 2: Fires can be a major disaster. Rationale 3: Wildfires are natural disasters. Rationale 4: Since arson fires are man-made, they would be included in this plan

Question 7 Type: MCSA A medical unit nurse manager is conducting an interview of a potential employee. Which strategy should the manager use? 1. Document first impressions of the applicant. 2. Review the rsum during the interview. 3. Use closed questions to elicit more information. 4. Use work sample questions to determine knowledge.

Correct Answer: 4 Rationale 1: First impressions may lead to premature judgments and hasty decisions. Rationale 2: The rsum should be reviewed alone prior to the initiation of the interview. Rationale 3: Closed questions elicit yes or no answers and do not provide much information. Rationale 4: Work sample questions are used to determine an applicants knowledge about work tasks and ability to perform the job.

A nurse has been discovered using drugs on the unit. Investigation reveals the nurse has likely been diverting and abusing narcotics for some time. What is the likely the worst outcome for this nurse? 1. Administration reports the nurse to the state board of nursing. 2. The nurse is counseled and asked to participate in a treatment center plan. 3. The nurse is allowed to continue supervised practice while a treatment plan is being devised. 4. The nurse is terminated with no report made.

Correct Answer: 4 Rationale 1: If this occurs, the nurse is likely to be offered some kind of assistance back into health and the profession. Rationale 2: If the nurse agrees to treatment, help is forthcoming. Rationale 3: In this case the nurse is supervised and a treatment plan is forthcoming. Rationale 4: If the nurse is terminated, employment at another facility may occur and the cycle may continue.

The standard method of appraisal used by the facility rates a nurses performance as satisfactory, but the nurse manager feels the nurse has room for improvement in many areas. What action should be taken by the manager? 1. Ask another staff nurses opinion of the situation. 2. Address the situation with the chief nursing officer. 3. Submit the appraisal as computed by the standard form. 4. Focus on developing a plan to improve the areas concerned.

Correct Answer: 4 Rationale 1: It is not ethical to share this dilemma with another staff nurse. Rationale 2: An astute nurse manager can address this issue without involving the chief nursing officer. Rationale 3: If the nurse manager just submits the appraisal as computed by the standard form, the opportunity to improve the nurses practice is lost. Rationale 4: In this situation, the nurse does not match the method of appraisal used by the facility. The nurse manager should go beyond the form and strive to help this nurse improve his or her practice.

Question 24 Type: MCSA A newly hired nurse has incurred two absences within two pay periods. The nurse manager has scheduled a meeting with the nurse. What other action should the manager plan in addressing this issue? 1. Have a person from human resources (HR) present when confronting the nurse. 2. Discuss the absenteeism with the nurse and then forget the issue. 3. Discuss the issue of absenteeism and other nurses who have had similar experiences when first hired. 4. Document the absences, review the attendance policy with the nurse, and provide a copy of the policy.

Correct Answer: 4 Rationale 1: It is not necessary to have HR present at this meeting since this is the nurses first occurrence with absenteeism. Rationale 2: The absenteeism needs to be addressed and monitored in the future to determine the nurses progress. Rationale 3: It is not appropriate to discuss the absence experiences of other nurses. Rationale 4: The manger should document the absences so they can be monitored and discussed. The manager should discuss and present the attendance policy to clarify possible misconceptions by the nurse and to be clear about the consequences of future issues relating to absenteeism.

An ICU unit has experienced an influx of aggressive behaviors by visitors against nurses. The ICU manager has instituted a policy to limit visiting hours. An employee asks the manager why the change in visiting hours has been implemented. Which response is likely the most accurate? 1. The unit has been so busy, I must allow for the nurses to have time to provide client care. 2. The visitor hours have not been adjusted in years. It was time to change them. 3. The physicians have requested limited visiting hours. 4. The visiting hours allowed for added stress and commotion to the nursing staff.

Correct Answer: 4 Rationale 1: It is true that nurses need time to care for clients, but this is probably not the real reason for the change. Rationale 2: Visiting hours are not changed simply because they have not been changed in years. Rationale 3: There is no indication that the physicians have anything to do with changing these hours. Rationale 4: Open visiting hours do allow for added stress and commotion. When visitors are aggressive toward nurses, restricting visiting hours may be essential.

The emergency department (ED) staff has been caring for a client who exhibited violent behavior when pain medication was denied. Once the situation was resolved, which action by the ED manager would be appropriate? 1. Arrange an agreement with law enforcement for rapid response on these incidents. 2. Post a sign stating that pain management medications are not given unless the client is admitted to the hospital. 3. Develop a team of staff who would be on call for these types of situations. 4. Organize a training program to educate staff on how to manage these types of situations.

Correct Answer: 4 Rationale 1: It is unlikely that the manager has the authority to institute such an arrangement. The staff also must know what to do until security or law enforcement arrives. Rationale 2: It is not possible to eliminate the use of pain medications in the ED. Rationale 3: Such a team might help in some situations, but the staff must still know what to do until they arrive. Rationale 4: The staff needs to be prepared in case of an emergency such as this one. This preparedness can occur through education.

Question 24 Type: MCSA A nurse who has accepted a position as an assistant ICU manager is discussing unionization with the human resources (HR) director. The HR director says the nurse cannot join the union. What rationale should the HR director offer for this statement? 1. The nurse has never been in a union in the past. 2. The nurse must first complete orientation before being eligible to join the union. 3. The nurse must have worked in a hospital environment for at least 5 years. 4. Registered nurses hired as management are not eligible for collective bargaining.

Correct Answer: 4 Rationale 1: Not being in a union in the past is not a valid rationale. Rationale 2: Completing orientation is not pertinent in this situation. Rationale 3: Length of employment is not pertinent to this situation. Rationale 4: Registered nurses employed as staff nurses are eligible for collective bargaining, but nurses who are employed as managers are not.

Question 6 Type: MCSA What is the best strategy the nurse manager can use to help retain nursing staff? 1. Relieve staff of the need to serve on committees in the institution. 2. Hire younger employees. 3. Require that the nurse sign a contract for at least 1 year of service. 4. Closely review applicants previous job history for length of commitment

Correct Answer: 4 Rationale 1: Nursing must be represented on committees to retain a sense of ownership of the organization. Rationale 2: Age of the employee has less to do with commitment than the persons mobility, which may be affected by age and responsibilities. Rationale 3: Contracts are easily broken. Making the nurse feel that there is a 1-year commitment may result in a nurse who is unhappy and ineffective in the job. A one-year commitment does not reduce turnover. Rationale 4: A review of a job applicants history of employment will give the nurse manager an idea of his or her past commitment to the workplace.

Adopting which strategy would be helpful in reducing recency error in staff appraisals? 1. Being careful not to overrate employees 2. Evaluating each behavior separately and fairly 3. Carefully defining performance standards 4. Recording critical incidents as they occur

Correct Answer: 4 Rationale 1: Overrating employees is leniency error. Recency error can result in either overrating or underrating an employee. Rationale 2: This strategy is not helpful if the manager remembers only behaviors that occurred recently. Rationale 3: Carefully defining performance standards is a good idea but is not helpful to the manager who does not remember facts about a particular employee. Rationale 4: Recency error is the tendency of a manager to remember only what has occurred with an employee recently. To combat recency error, the manager should keep notes on critical incidents in the employees work as they occur.

Question 5 Type: MCSA A new graduate nurse is preparing for an interview by the nurse recruiter. The applicant should be ready to be asked questions about which topic? 1. General state of health 2. Availability of transportation to work 3. Previous military service 4. Willingness to work all shifts

Correct Answer: 4 Rationale 1: Questions about general medical condition, state of health, or specific diseases are inappropriate. Rationale 2: Questions about availability of transportation to work are not appropriate. Rationale 3: Questions about previous military service are not appropriate. Rationale 4: Questions about the applicants willingness to work the required work schedule are appropriate.

Question 29 Type: MCSA An outbreak of smallpox has followed a national sporting event. Terrorist activity is suspected. How would this event be categorized? 1. As a natural, biologic disaster 2. As a man-made, chemical disaster 3. As a natural, radiological disaster 4. As a man-made, biologic disaster

Correct Answer: 4 Rationale 1: Since terrorism is involved, it is not a natural disaster. Rationale 2: Since the substance used was smallpox, it is not a chemical disaster. Rationale 3: Since the substance used was smallpox, it is not a radiological disaster and it is not natural. Rationale 4: The dispersion of the biologic agent in this case is thought to be man-made.

Question 9 A nurse manager tells the human resources (HR) director, I would really like to hire someone of another race to balance out the team. The HR director tells the manager recruiting and hiring based on race is in violation of which statute? 1. The Equal Pay Act of 1963 2. Age Discrimination Act 3. Americans with Disabilities Act 4. Title VII of the Civil Rights Act

Correct Answer: 4 Rationale 1: The Equal Pay Act of 1963 aimed to eliminate wage disparities based on sex. Rationale 2: The Age Discrimination Act prohibits discrimination against applicants and employees over the age of 40. Rationale 3: The Americans with Disabilities Act prohibits discrimination based on an individual's disability. Rationale 4: Title VII of the Civil Rights Act specifically prohibits discrimination in any personnel decisions based on race, color, sex, religion, or national origin.

Question 9 Type: MCSA A nurse manager tells the human resources (HR) director, I would really like to hire someone of another race to balance out the team. The HR director tells the manager recruiting and hiring based on race is in violation of which statute? 1. The Equal Pay Act of 1963 2. Age Discrimination Act 3. Americans with Disabilities Act 4. Title VII of the Civil Rights Act

Correct Answer: 4 Rationale 1: The Equal Pay Act of 1963 aimed to eliminate wage disparities based on sex. Rationale 2: The Age Discrimination Act prohibits discrimination against applicants and employees over the age of 40. Rationale 3: The Americans with Disabilities Act prohibits discrimination based on an individuals disability. Rationale 4: Title VII of the Civil Rights Act specifically prohibits discrimination in any personnel decisions based on race, color, sex, religion, or national origin.

Question 8 Type: MCSA As a cost-saving initiative, the hospital administration has asked the night staff nurses to refill drug supplies at night while the pharmacist is not present. The nurses file a grievance and nurse managers become involved. How would this grievance be classified? 1. Violation of agency rules 2. Contract violation 3. Failure of management to meet its responsibilities 4. Violation of federal and state laws

Correct Answer: 4 Rationale 1: The agency could make a new rule that allows this practice. Rationale 2: It is unlikely that this scenario would be covered in the contract. Rationale 3: This is the second best answer to this question. Rationale 4: Nurses cannot act as substitute pharmacists.

A nurse comes to the unit manager to report a coworker's behavioral changes. The nurse has noticed that the coworkers handwriting has become shaky and illegible, that the coworker has mood swings, and that the coworker has had increased tardiness. Which should be the managers first action? 1. Meet with the coworker in private and discuss the behaviors. 2. Meet with other staff to determine if the coworker has issues at home. 3. Meet with human resources (HR) to determine the best method to terminate the employee. 4. Collect additional information regarding behaviors, absenteeism, and/or tardiness.

Correct Answer: 4 Rationale 1: The manager will meet with the nurse but should have information to support the investigation of substance abuse. Rationale 2: Obtaining information from other staff is unprofessional and violates confidentiality. Rationale 3: The manager should meet with HR to determine a course of action but should have documentation to support suspected abuse prior to HRs involvement. Rationale 4: The manager should obtain information and documentation to determine if there is a problem.

Which statement would be inappropriate for a manager to write on an employees performance appraisal? 1. The nurses attitude positively affects coworkers. 2. The nurse seeks learning experiences. 3. The nurse is frequently tardy. 4. The nurse is shy and quiet.

Correct Answer: 4 Rationale 1: The nurses attitude is important because of its effect on coworkers, which the manager can see or measure. Rationale 2: Seeking learning experiences is something the manager can see or measure. Rationale 3: Tardiness is something that can be measured. Rationale 4: A performance appraisal must focus on an individuals job performance and not personal characteristics. Shy and quiet are personal characteristics. If the nurse has impaired communication skills because of being too shy and quiet, then that is related to job performance.

Question 4 A nurse writes some scathing remarks about another nurse's professionalism on a social media site. A complaint of bullying is lodged with the nurse manager. Which statement by the manager is appropriate? 1. I have no control over what the nurses do on their time away from work. 2. This does not meet the standards for bullying because it was not a face-to-face encounter. 3. You two are acting like a couple of high school kids. 4. I will follow up on this complaint and take action as needed.

Correct Answer: 4 Rationale 1: The remarks were about the nurse's professionalism, which is a part of the nurse's work. The manager does have input into this situation. Rationale 2: Bullying can occur on the Internet, by text message, or face-to-face. Rationale 3: This is not an appropriate or helpful remark for the manager to make in this situation. Rationale 4: The manager must do an assessment of the complaint before acting.

Question 10 Type: MCSA A union has won a representative election. What right does that union now hold? 1. The right to represent all employees of the hospital 2. The right to forbid management from unilaterally changing employment conditions for employees outside the bargaining unit 3. The right to jointly negotiate expanded bargaining units with the employer after the election 4. The right to be the bargaining agent for a group of employees

Correct Answer: 4 Rationale 1: The union has the right to represent the group of employees covered by the election. For example, a nurses union may or may not include health care workers in the laboratory or radiology departments. Rationale 2: The union cannot effect change for employees outside of the bargaining unit. Rationale 3: The union cannot expand to another unit without an election. Rationale 4: The union that wins the election then has the right to enter into contract negotiations with the organization on behalf of the employees.

Question 2 The nurse executive works hard to create a civil workplace that does not tolerate harassing behaviors. How would this nurse best explain the reason for this emphasis on civility? 1. Bullying behaviors make nurses uncomfortable. 2. Physicians do not want to admit clients to hospitals with an uncivil atmosphere. 3. Bullying and incivility are just not proper work practices. 4. Bullying and incivility are dangerous to client care.

Correct Answer: 4 Rationale 1: This is a reason for not tolerating harassing behaviors, but is not the most important reason. Rationale 2: It is true that incivility may decrease the number of clients admitted to a hospital, but this is not the primary reason for this work. Rationale 3: Bullying and incivility are not proper work practices, but this is not the primary reason for excluding them from the workplace. Rationale 4: These behaviors can be dangerous to clients.

Question 18 Type: MCSA A union representative tells the nurses of a hospital that they should review the Kentucky River trilogy as part of their education regarding unionization. What will the nurses learn from this review? 1. A summary of the benefits of collective bargaining in the health care industry 2. The history of unionization in the United States 3. What the nurse can expect to pay as a member of the collective bargaining unit 4. Which nurses are considered to have supervisory status

Correct Answer: 4 Rationale 1: This is not the focus of this work. Rationale 2: This is not the focus of this work. Rationale 3: This is not the focus of this work. Rationale 4: These three landmark decisions outline which nurses have supervisory status. Global Rationale:

Question 14 Type: MCSA A grievance has been filed against a hospital whose nursing staff has just established a union. What is the nurse executives first step? 1. Call the union representative for a meeting to discuss the grievance. 2. Call managers together to discuss the grievance. 3. Notify staff nurses that the grievance has been received. 4. Review the agreement for information about grievances.

Correct Answer: 4 Rationale 1: This may be a wise idea, but it is not the first step. Rationale 2: This may be a wise idea, but it is not the first step. Rationale 3: This is not the first step. Rationale 4: The nurse executives first step should be to review the agreement with the union. This agreement will describe the steps and progression of a grievance.

Question 6 Type: MCSA A client's spouse is concerned about the cost of hospitalization. The nurse says, Since your spouse is on Medicare, the hospital will be paid according to the DRG. What does the nurse mean by this statement? 1. Medicare will pay the total cost for the care provided. 2. Medicare will pay an average of the total costs. 3. Medicare will pay based on the usual cost of the treatments provided. 4. Medicare will pay based on a set amount for the specific condition for which the client was hospitalized.

Correct Answer: 4 Rationale 1: Total cost is the amount of the charges for which the client is billed. Medicare reimbursement does not equal this amount. Rationale 2: An average for the costs is not a payer amount used by the health care industry. Rationale 3: Medicare does not pay based upon the usual cost of the procedure. Rationale 4: Medicare payment for inpatient services is currently made at a predetermined specific rate for each Medicare recipient based on the patients' diagnosis. Care is classified into diagnosis-related groups (DRGs).

Question 6 Type: MCSA The housekeeping employee asks the employees agent what role the union representative plays. What answer should the agent provide? 1. They will set wages for union members. 2. They are responsible for writing floating policy for administration. 3. They oversee the retirement funds. 4. They are responsible for administering the contract.

Correct Answer: 4 Rationale 1: Wages are set in the contract. Rationale 2: Policies are negotiated in the contract. Rationale 3: Retirement funds are negotiated in the contract. Rationale 4: The role of administering the contract falls to an individual designated as the union representative.

Question 12 Type: MCSA Despite the nurse managers best efforts to retain an experienced nurse, the nurse leaves for a job in a competing hospital. Which option reflects the most important thing the manager must do now? 1. Find a replacement to hire. 2. Have human resources interview the nurse who left. 3. Manage personal feelings of defeat. 4. Decrease the impact of the hospital grapevine.

Correct Answer: 4 Rationale 1: While finding a replacement for the nurse is important, it is not the primary concern. Rationale 2: An exit interview is important, but is not the managers primary concern. Rationale 3: The manager may feel defeated by losing this nurse, but this is not the primary concern. Rationale 4: This nurse is gone, so the managers next task it to decrease the impact of the hospital grapevine. This informal, but powerful, information superhighway can spread inaccurate and inflammatory information rapidly and could influence other nurses to leave.

Which strategies would decrease the amount of time the nurse manager spends with drop-in visitors to the managers office? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Set office hours to eliminate those visits. 2. Keep the office door closed. 3. Arrange furniture so the desk faces the door. 4. Stand up to greet the visitor and remain standing.

Correct Answer: 4,5 Rationale 1: Office hours should be established to decrease drop-in visits, but the intent is not to totally eliminate them Rationale 2: Keeping the door closed is incorrect because a block of time when the door is open for accessibility and availability is needed. Rationale 3: If the desk faces the door, eye contact is made with passersby and anyone who is standing in the doorway, which invites interruption. Rationale 4: In order to redirect the drop-in visit, the nurse manager should stand up and remain standing throughout the encounter. This gesture is gracious yet obvious enough to encourage a short visit. Rationale 5: Encouraging appointments for routine matters is an effective solution. The manager should indicate that in order to have sufficient time to address the question, a block of time will be needed.

Which activities are similar enough that they could be grouped to better manage time? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Restocking the medication cart 2. Discussing a diet request with a new client 3. Calling for extra linen from laundry 4. Search the Internet for an unfamiliar client diagnosis 5. E-mailing a colleague a question about the schedule

Correct Answer: 4,5 Rationale 1: Restocking the medication cart takes attention to detail. This task should not be combined with other tasks. Rationale 2: The nurse should pay full attention to the client and not combine this with other activities. Rationale 3: Calling for extra linen is unlike any other task in this list and would not make a suitable fit for task combination. Rationale 4: While the nurse is logged into the computer, searching for a client diagnosis on the Internet would combine well with e-mailing a colleague. Rationale 5: The nurse could easily e-mail a colleague and search for information about a client diagnosis while logged into the computer in one session.